Individual provider Active NPI

Carmen Renee Sekulic, CRNA

  • Certified Registered Nurse Anesthetist
  • Cleveland, OH
National Provider Identifier
1376720474
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.09867 Issued in OH
Practice address
18101 Lorain Ave
Cleveland, OH 44111-5612
Phone
(216) 476-7052
NPI assigned
Jan 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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 APRN.CRNA.09867 OH Primary

Addresses

Primary practice location

18101 Lorain Ave
Cleveland, OH 44111-5612

Mailing address

PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-5072

Other practice location 1

3333 W Tech Rd
Miamisburg, OH 45342-0955
Phone (937) 641-3880

Other practice location 2

1 Childrens Plz
Dayton, OH 45404-1815
Phone (937) 641-3477

Other identifiers 1

IdentifierTypeStateIssuer
2821736MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080305000006 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254416027 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
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)

9985 Dayton Lebanon Pike
Dayton, OH 45458-4231
Phone (937) 886-2980

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CRNA.09867OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sandusky Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients
Dayton Children'S Specialty Physicians, Inc. Nurse Anesthetist, Certified Registered CurrentSince May 1, 2002 Accepting new patients
Dayton Children'S Specialty Physicians, Inc. CurrentSince May 1, 2002 Accepting new patients
Westgate Pain Management Group, LLC Past Accepting new patients
Westgate Medical Anesthesia Group Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

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

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

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

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

3333 W Tech Rd
Miamisburg, OH 45342
Phone (937) 641-3400

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": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1376720474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 LORAIN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115612",
            "telephone_number": "216-476-7052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-3880",
            "fax_number": "937-641-6159",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Plz",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454041815",
            "country_code": "US",
            "telephone_number": "937-641-3477",
            "fax_number": "937-641-5410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEKULIC",
        "first_name": "CARMEN",
        "middle_name": "RENEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.09867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2821736",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.