Individual provider Active NPI

Kevin P Burman, CRNA

  • Certified Registered Nurse Anesthetist
  • Chehalis, WA
National Provider Identifier
1457674640
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60140049 Issued in WA
Practice address
2517 NE Kresky Avenue
Chehalis, WA 98532-2409
Phone
(360) 748-8632
Fax
(360) 748-3869
NPI assigned
Mar 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN619028 CA
Certified Registered Nurse Anesthetist 367500000X 46909 ID
Certified Registered Nurse Anesthetist 367500000X NUR-RN-LIC-71934 MT
Certified Registered Nurse Anesthetist 367500000X 201394417CRNA OR
Certified Registered Nurse Anesthetist 367500000X CRNA-0182 NM
Certified Registered Nurse Anesthetist 367500000X NURA428 AK
Certified Registered Nurse Anesthetist 367500000X AP60140049 WA Primary

Addresses

Primary practice location

2517 NE Kresky Avenue
Chehalis, WA 98532-2409

Mailing address

PO Box 1506
Chehalis, WA 98532-1439
Phone (360) 242-3008

Other identifiers 11

IdentifierTypeStateIssuer
20004631OtherIDMEDICARE ID
500670615MedicaidOR
G8923257OtherWAMEDICARE WA
G8926234OtherWAMEDICARE WA
M011004119OtherMTMEDICARE MT
1457674640MedicaidID
2005970MedicaidWA
324226YWN7OtherNMMEDICARE NM
R174152OtherORMEDICARE OR
CRNA082826OtherNATIONAL CRNA CERTIFICATION
K165387OtherAKMEDICARE AK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asc.pclichehalis.p1@direct.pcli.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AK, NM, MT, OR, ID6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20100804000650 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284767765 Reassigns benefits to 1 organization
I20131227000058 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284767765 Reassigns benefits to 1 organization
I20131228000190 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284767765 Reassigns benefits to 1 organization
I20140115001619 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284767765 Reassigns benefits to 1 organization
I20140407000375 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284767765 Reassigns benefits to 1 organization
I20140512001586 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284767765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Cataract and Laser Institute Inc PCGroup PAC ID 7517864119, shared by 15 NPIs, 75 clinicians
Pacific Cataract and Laser Institute of Alaska Inc PCGroup PAC ID 4486549300, 13 clinicians

Practice addresses (Care Compare)

1331 NW Lovejoy St
Suite 750
Portland, OR 97209-2799
Phone (503) 535-2883

1600 A St
Suite 200
Anchorage, AK 99501-5147
Phone (907) 272-2423

1621 Market Place Dr
Great Falls, MT 59404-3480
Phone (406) 454-2202

2517 NE Kresky Ave
Chehalis, WA 98532-2433
Phone (360) 748-8632

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN619028CAMDCertified Registered Nurse Anesthetist
46909IDMDCertified Registered Nurse Anesthetist
CRNA-0182NMMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients
Pacific Cataract and Laser Institute, Inc., P.C. Current Accepting new patients
Pacific Cataract and Laser Institute Inc PC CurrentSince Sep 19, 2013 Accepting new patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients
Pacific Cataract and Laser Institute Inc PC CurrentSince Dec 10, 2013 Accepting new patients
Pacific Cataract and Laser Institute, Inc., P.C. CurrentSince Jan 2, 2014 Accepting new patients
Pacific Cataract and Laser Institute, Inc., P.C. Current Accepting new patients
Pacific Cataract and Laser Institute, Inc., P.C. CurrentSince Sep 19, 2013 Accepting new patients
NPI 1245471788 CurrentSince Dec 6, 2013 Accepting new patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients
Pacific Cataract and Laser Institute Inc PC CurrentSince Dec 11, 2013 Accepting new patients
Pacific Cataract and Laser Institute of Alaska Inc PC CurrentSince Dec 6, 2013 Accepting new patients

Locations

1600 A St
Ste 200
Anchorage, AK 99501
Phone (907) 272-2423

2822 S Vista Ave
Boise, ID 83705
Phone (208) 385-7576

3330 4th St
Lewiston, ID 83501
Phone (208) 746-2025

1621 Market Place Dr
Great Falls, MT 59404
Phone (406) 454-2202

8220 San Pedro Dr NE
Ste 220
Albuquerque, NM 87113
Phone (360) 242-4610

1331 NW Lovejoy St
Ste 750
Portland, OR 97209
Phone (503) 535-2883

19801 SW 72nd Ave
Ste 150
Tualatin, OR 97062
Phone (503) 691-2283

2606 116th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 462-7664

4330 Mitchell Way
Bellingham, WA 98226
Phone (360) 736-6860

2517 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 748-8632

6695 W Rio Grande Ave
Kennewick, WA 99336
Phone (509) 736-0826

115 New View Ct NE
Olympia, WA 98506
Phone (360) 252-1642

9598 Mickelberry Rd NW
Silverdale, WA 98383
Phone (360) 698-5062

16818 E Desmet Ct
Spokane Valley, WA 99216
Phone (360) 242-3008

2915 S Alder St
Tacoma, WA 98409
Phone (253) 473-0275

2205 NE 129th St
Vancouver, WA 98686
Phone (360) 450-6644

3900 Kern Rd
Yakima, WA 98902
Phone (509) 966-1356

Interoperability endpoints

  • Direct secure messaging: asc.pclichehalis.p1@direct.pcli.nextgenshare.com
  • Direct secure messaging: kevin.burman.p1@direct.pcli.nextgenshare.com

Organizations & group practices 11

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1457674640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1506",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985321439",
            "telephone_number": "360-242-3008",
            "fax_number": "360-807-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2517 NE KRESKY AVENUE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322409",
            "telephone_number": "360-748-8632",
            "fax_number": "360-748-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURMAN",
        "first_name": "KEVIN",
        "middle_name": "P",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-02",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "RN619028",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "46909",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "NUR-RN-LIC-71934",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201394417CRNA",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "CRNA-0182",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AK",
            "license": "NURA428",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60140049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "20004631",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500670615",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "G8923257",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE WA",
            "identifier": "G8926234",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MT",
            "identifier": "M011004119",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457674640",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005970",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NM",
            "identifier": "324226YWN7",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OR",
            "identifier": "R174152",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CRNA CERTIFICATION",
            "identifier": "CRNA082826",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE AK",
            "identifier": "K165387",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asc.pclichehalis.p1@direct.pcli.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2517 NE Kresky Avenue",
            "city": "Chehalis",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985322409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.