Individual provider Active NPI

Kyle P Pelc

  • Certified Registered Nurse Anesthetist
  • Columbus, OH
National Provider Identifier
1285115899
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
019734 Issued in OH
Practice address
44 Radio City Blvd
Columbus, OH 43235-8936
Phone
(740) 501-6437
NPI assigned
Aug 22, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 363744 OH
Certified Registered Nurse Anesthetist 367500000X 019734 OH Primary

Addresses

Primary practice location

44 Radio City Blvd
Columbus, OH 43235-8936

Mailing address

44 Radio City Blvd
Columbus, OH 43235-8936
Phone (740) 501-6437

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181029002278 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486907078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knox Community HospitalGroup PAC ID 1153301833, 117 clinicians

Practice addresses (Care Compare)

1330 Coshocton Ave
Mount Vernon, OH 43050-1495
Phone (740) 393-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
363744OHMDRegistered Nurse
019734OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Knox Community Hospital CurrentSince Aug 31, 2021 Accepting new patients
Knox Community Hospital CurrentSince Aug 31, 2021 Accepting new patients
Knox Community Hospital Current Accepting new patients
Knox Community Hospital Current Accepting new patients
Knox Community Hospital Current Accepting new patients
New Albany Orthopedic Anesthesia LLC CurrentSince Oct 8, 2018 Accepting new patients

Locations

3600 Stelzer Rd
Ste 100
Columbus, OH 43219
Phone (614) 255-2900

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019

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 and National Provider Directory roles.

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": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1285115899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 RADIO CITY BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432358936",
            "telephone_number": "740-501-6437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 RADIO CITY BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432358936",
            "telephone_number": "740-501-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELC",
        "first_name": "KYLE",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "363744",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "019734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.