Individual provider Active NPI

Kseniya Luz, CRNA

  • Certified Registered Nurse Anesthetist
  • Oklahoma City, OK
National Provider Identifier
1457029605
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
205319 Issued in OK
Practice address
3100 SW 89TH St
Oklahoma City, OK 73159-7900
Phone
(405) 602-8100
NPI assigned
Sep 2, 2021
Last updated
Sep 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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 205319 OK Primary

Addresses

Primary practice location

3100 SW 89TH St
Oklahoma City, OK 73159-7900

Mailing address

1940 S Woodlawn Blvd Apt 203
Wichita, KS 67218-4747
Phone (617) 970-0519

Other practice location 1

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 474-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211011000144 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991103640 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Anthony Shawnee Hospital IncGroup PAC ID 1052567328, 15 clinicians

Practice addresses (Care Compare)

1102 W Macarthur St
Shawnee, OK 74804-1743
Phone (405) 878-8110

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.2 of 100Reported as group
Quality
93.03
Promoting interoperability
100
Improvement activities
40
Cost
93.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
205319OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Anthony Shawnee Hospital Inc CurrentSince Aug 11, 2022 Accepting new patients
Hpi Physicians LLC CurrentSince Oct 1, 2021 Accepting new patients
SSM Health Care of Oklahoma Inc CurrentSince Apr 1, 2022 Accepting new patients
St Anthony Shawnee Hospital Inc Current Accepting new patients
St. Anthony Shawnee Hospital, Inc. CurrentSince Aug 11, 2022 Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

1705 Renaissance Blvd
Ste 120
Edmond, OK 73013
Phone (405) 715-4496

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

14024 Quail Pointe Dr
Oklahoma City, OK 73134
Phone (405) 419-8447

3100 SW 89th St
Oklahoma City, OK 73159
Phone (405) 602-8100

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1457029605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 S WOODLAWN BLVD APT 203",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672184747",
            "telephone_number": "617-970-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SW 89TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597900",
            "telephone_number": "405-602-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Belle Terre Rd",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117771928",
            "country_code": "US",
            "telephone_number": "631-474-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUZ",
        "first_name": "KSENIYA",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "205319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.