Individual provider Active NPI

Kimberly A Amouzgar, CRNA

  • Certified Registered Nurse Anesthetist
  • Stoughton, MA
National Provider Identifier
1275712291
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
227274 Issued in MA
Practice address
255 Plain Drive
C/O Ma Anesthesia Corp.
Stoughton, MA 02072
Phone
(781) 344-2325
Fax
(781) 341-8269
NPI assigned
Oct 26, 2007
Last updated
Jun 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 227274 MA Primary

Addresses

Primary practice location

255 Plain Drive
C/O Ma Anesthesia Corp.
Stoughton, MA 02072

Mailing address

PO Box 372
Massachusetts Anesthesia Corp.
Stoughton, MA 02072
Phone (781) 407-7713

Other names 1

  • Kimberly A Amouzgor Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110408000195 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305020769 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Anesthesia Associates PLLCGroup PAC ID 0042675282, 29 clinicians
Pratt Anesthesiology Associates IncGroup PAC ID 0547151151, 153 clinicians

Practice addresses (Care Compare)

40 Allied Dr
Dedham, MA 02026-6146
Phone (617) 865-1110

585 Lebanon St
Melrose, MA 02176-3225
Phone (781) 979-3000

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-6044

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
227274MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Anesthesiology Associates, Inc CurrentSince Jul 1, 2019 Accepting new patients
Excel Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 6, 2024 Accepting new patients
Dha Endoscopy LLC CurrentSince Jul 26, 2020 Accepting new patients
Gbaa Holdings, PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2020 Accepting new patients
Dha Endoscopy LLC CurrentSince Jul 26, 2020 Accepting new patients
Anesthesia Providers of Massachusetts LLC PastSince Oct 16, 2014 Accepting new patients

Locations

45 Discovery Way
#A
Acton, MA 01720
Phone (617) 936-7683

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

40 Allied Dr
Dedham, MA 02026
Phone (617) 264-1100

105 Erdman Way
Leominster, MA 01453
Phone (978) 466-7800

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

91 Montvale Ave
Ste 103
Stoneham, MA 02180
Phone (781) 835-2111

175 Worcester St
Wellesley Hls, MA 02481
Phone (617) 272-0004

120 W Center St
West Bridgewater, MA 02379
Phone (508) 230-8181

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1275712291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "address_2": "MASSACHUSETTS ANESTHESIA CORP.",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "02072",
            "telephone_number": "781-407-7713",
            "fax_number": "781-407-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 PLAIN DRIVE",
            "address_2": "C/O MA ANESTHESIA CORP.",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "02072",
            "telephone_number": "781-344-2325",
            "fax_number": "781-341-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOUZGAR",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-26",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "227274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "AMOUZGOR",
            "middle_name": "A",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stoughton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.