Individual provider Active NPI

Ruth Kulesza, CRNA

  • Certified Registered Nurse Anesthetist
  • Johnson City, NY
National Provider Identifier
1295770485
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
539981 Issued in NY
Practice address
156 Corliss Ave
Suite 107
Johnson City, NY 13790-2060
Phone
(607) 763-6735
NPI assigned
Jun 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 539981 NY Primary

Addresses

Primary practice location

156 Corliss Ave
Suite 107
Johnson City, NY 13790-2060

Mailing address

156 Corliss Ave
Suite 107
Johnson City, NY 13790-2060
Phone (607) 763-6735

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080808000290 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678647609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maple City Anesthesia LLCGroup PAC ID 7214024488, 8 clinicians

Practice addresses (Care Compare)

1860 Fair Ave
B
Honesdale, PA 18431-2108
Phone (570) 253-6688

Merit-based Incentive Payment System (MIPS)

Final score
91.55 of 100Reported as group
Quality
83.1
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maple City Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2008 Accepting new patients
Mountain Laurel Surgery Center, LLC PastSince Aug 1, 2008 Accepting new patients

Locations

1860 Fair Ave
#B
Honesdale, PA 18431
Phone (570) 253-6688

1860 Fair Ave
Honesdale, PA 18431
Phone (570) 253-3391

Interoperability endpoints

  • Direct secure messaging: rkulesza@gastrohonesdale.medentdirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295770485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 CORLISS AVE",
            "address_2": "SUITE 107",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902060",
            "telephone_number": "607-763-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 CORLISS AVE",
            "address_2": "SUITE 107",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902060",
            "telephone_number": "607-763-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULESZA",
        "first_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "539981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.