Individual provider Active NPI

Kimberly Marie Choudhary, CRNA

  • Certified Registered Nurse Anesthetist
  • Cleveland, OH
National Provider Identifier
1427329556
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
13077 Issued in OH
Practice address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone
(216) 844-7330
NPI assigned
Jan 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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 13077 OH Primary

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Mailing address

2222 Detroit Ave
Apt 510
Cleveland, OH 44113-2453
Phone (718) 207-8537

Other identifiers 2

IdentifierTypeStateIssuer
P01071257OtherOHMEDICARE RAILROAD
0064530MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120216000229 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103084447 Reassigns benefits to 1 organization
I20241011000823 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103084447 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Treasure Coast Anesthesia Group PAGroup PAC ID 2567600588, 98 clinicians

Practice addresses (Care Compare)

1210 S Old Dixie Hwy
Jupiter, FL 33458-7205
Phone (954) 939-5000

200 SE Hospital Ave
Stuart, FL 34994-2346
Phone (772) 287-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13077OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Coast Anesthesia Group PA Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2024 Accepting new patients
Jupiter Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2024 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Mar 1, 2012 Accepting new patients
Jupiter Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2024 Accepting new patients

Locations

1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073

2100 SE Salerno Rd
Stuart, FL 34997
Phone (772) 223-2300

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Organizations & group practices 4

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 2

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": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1427329556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 DETROIT AVE",
            "address_2": "APT 510",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441132453",
            "telephone_number": "718-207-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUDHARY",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-20",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "13077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01071257",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0064530",
            "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 Sep 27, 2012; 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.