Individual provider Active NPI

Christopher Koke, CRNA

  • Certified Registered Nurse Anesthetist
  • Buffalo, NY
National Provider Identifier
1356696686
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.019526 Issued in OH
Practice address
2157 Main St
Buffalo, NY 14214-2648
Phone
(716) 836-7510
Fax
(716) 836-7511
NPI assigned
Jul 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 579493 NY
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.019526 OH Primary

Addresses

Primary practice location

2157 Main St
Buffalo, NY 14214-2648

Mailing address

2121 Main St
Suite 209
Buffalo, NY 14214-2693
Phone (716) 836-7510

Other practice location 1

75 Sylvania Dr
Dayton, OH 45440-3237
Phone (937) 320-5050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170802003085 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446408082 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Anesthesia Associates, IncGroup PAC ID 0648170365, 54 clinicians

Practice addresses (Care Compare)

1625 Delco Park Dr
Dayton, OH 45420-1391
Phone (937) 535-2200

Hospital & facility affiliations

  • Wayne Hospital Hospital, Greenville, OH, CCN 361335

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sandusky Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 19, 2022 Accepting new patients

Locations

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

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.

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": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1356696686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 MAIN ST",
            "address_2": "SUITE 209",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142693",
            "telephone_number": "716-836-7510",
            "fax_number": "716-836-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142648",
            "telephone_number": "716-836-7510",
            "fax_number": "716-836-7511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Sylvania Dr",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454403237",
            "country_code": "US",
            "telephone_number": "937-320-5050",
            "fax_number": "937-320-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOKE",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "579493",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.019526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.