Individual provider Active NPI

Carly Krumnow Peschke, CRNA

  • Certified Registered Nurse Anesthetist
  • Austin, TX
National Provider Identifier
1386240133
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
131527 Issued in TX
Practice address
901 W Ben White Blvd
Austin, TX 78704-6903
Phone
(512) 447-2211
NPI assigned
Dec 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 859877 TX
Anesthesiology Physician 207L00000X 131527 TX
Certified Registered Nurse Anesthetist 367500000X 131527 TX Primary

Addresses

Primary practice location

901 W Ben White Blvd
Austin, TX 78704-6903

Mailing address

510 Gallagher Drive
Canyon Lake, TN 77133
Phone (361) 537-7026

Other names 1

  • Carly Brook Krumnow Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210303000207 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648686477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Anesthesiology Group PLLCGroup PAC ID 0547256497, 430 clinicians

Practice addresses (Care Compare)

1891 Medical Pkwy
San Marcos, TX 78666-7559
Phone (512) 754-7999

Hospital & facility affiliations

  • St David'S South Austin Medical Center Hospital, Austin, TX, CCN 450713

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
859877TXMDRegistered Nurse
131527TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Anesthesiology Group, PLLC Anesthesiology CurrentSince Feb 1, 2021 Accepting new patients
Austin Anesthesiology Group PLLC Anesthesiology CurrentSince Feb 1, 2021 Accepting new patients

Locations

4307 James Casey St
Austin, TX 78745
Phone (512) 416-6005

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

1111 W 34th St
Austin, TX 78705
Phone (512) 343-2466

12200 Renfert Way
Ste G-2
Austin, TX 78758
Phone (512) 901-8340

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

1201 W Louis Henna Blvd
Austin, TX 78681
Phone (512) 248-7000

12201 Renfert Way
Ste 120
Austin, TX 78758
Phone (512) 454-6753

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

16030 Park Valley Dr
Ste 100
Round Rock, TX 78681
Phone (512) 246-8777

1891 Medical Pkwy
San Marcos, TX 78666
Phone (512) 754-7999

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": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1386240133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 GALLAGHER DRIVE",
            "city": "CANYON LAKE",
            "state": "TN",
            "postal_code": "77133",
            "telephone_number": "361-537-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W BEN WHITE BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787046903",
            "telephone_number": "512-447-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESCHKE",
        "first_name": "CARLY",
        "middle_name": "KRUMNOW",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "859877",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "131527",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "131527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "KRUMNOW",
            "middle_name": "BROOK",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.