Individual provider Active NPI

Dean Canestrini, CRNA

  • Certified Registered Nurse Anesthetist
  • Paducah, KY
National Provider Identifier
1487745592
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3003564 Issued in KY
Practice address
2501 Kentucky Avenue
Western Baptist Hospital
Paducah, KY 42003
Phone
(270) 575-2100
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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 3003564 KY Primary

Addresses

Primary practice location

2501 Kentucky Avenue
Western Baptist Hospital
Paducah, KY 42003

Mailing address

2507 Broadway
Paducah, KY 42001
Phone (270) 442-8228

Other identifiers 2

IdentifierTypeStateIssuer
K023541OtherKYMEDICARE OF KY
74005463MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050926000300 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628002946 Reassigns benefits to 2 organizations
I20160115001100 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628002946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tas of Kentucky LLC 8 clinicians

Practice addresses (Care Compare)

1099 Medical Ctr Cir
Mayfield, KY 42066-1179
Phone (270) 251-4100

Hospital & facility affiliations

  • Jackson Purchase Medical Center Hospital, Mayfield, KY, CCN 180116

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Kentucky, PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2011 Accepting new patients
Tas of Kentucky LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2014 Accepting new patients
Lourdes Ambulatory Surgery Center, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Purchase Anesthesia, PSC Nurse Anesthetist, Certified Registered PastSince Apr 1, 2005 Accepting new patients
Resource Anesthesia, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

1000 Breckenridge St
Ste 100
Owensboro, KY 42303
Phone (270) 683-2751

225 Medical Center Dr
Ste 405
Paducah, KY 42003
Phone (270) 441-4750

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1487745592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 BROADWAY",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42001",
            "telephone_number": "270-442-8228",
            "fax_number": "270-442-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 KENTUCKY AVENUE",
            "address_2": "WESTERN BAPTIST HOSPITAL",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42003",
            "telephone_number": "270-575-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANESTRINI",
        "first_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3003564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OF KY",
            "identifier": "K023541",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74005463",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.