Individual provider Active NPI

Kyle Rodney Stevens, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Wayne, IN
National Provider Identifier
1508594870
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28232084A Issued in IN
Practice address
10315 Dawsons Creek Blvd Ste Ab
Fort Wayne, IN 46825-1912
Phone
(260) 436-7875
NPI assigned
Aug 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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 28232084A IN Primary

Addresses

Primary practice location

10315 Dawsons Creek Blvd Ste Ab
Fort Wayne, IN 46825-1912

Mailing address

PO Box 843603
Dallas, TX 75284-3603
Phone (972) 233-1999

Other identifiers 1

IdentifierTypeStateIssuer
1508594870MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221212000666 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688043821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Anesthesiologists of Fort Wayne PCGroup PAC ID 2264412444, 101 clinicians

Practice addresses (Care Compare)

1316 E 7TH St
Parkview Dekalb Hospital
Auburn, IN 46706-2538
Phone (260) 925-4600

2520 E Dupont Rd
Dupont Hospital
Fort Wayne, IN 46825-1675
Phone (260) 416-3000

701 Orthopaedic Dr
Warsaw, IN 46582-3904
Phone (260) 435-2999

702 Van Buren St
Fort Wayne, IN 46802-3697
Phone (260) 425-3000

7950 W Jefferson Blvd
Lutheran Hospital
Fort Wayne, IN 46804-4140
Phone (260) 435-7001

7952 W Jefferson Blvd
The Orthopedic Hosp of Lutheran HN
Fort Wayne, IN 46804-4140
Phone (260) 435-2999

820 Smaltz Way
Suite a
Auburn, IN 46706-0609
Phone (260) 909-6400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.76 of 100Reported as group
Quality
62.07
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28232084AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists of Fort Wayne PC Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2022 Accepting new patients
U S Anesthesia Partners of Kentucky PSC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients

Locations

1316 E 7th St
Auburn, IN 46706
Phone (260) 925-4600

10315 Dawsons Creek Blvd
Ste Ab
Fort Wayne, IN 46825
Phone (219) 436-7875

6435 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-7875

7920 W Jefferson Blvd
Ste 210
Fort Wayne, IN 46804
Phone (260) 434-2022

10215 Auburn Park Dr
Ste B
Fort Wayne, IN 46825
Phone (260) 490-4673

702 Van Buren St
Fort Wayne, IN 46802
Phone (260) 425-3000

7952 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 435-2999

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

2101 Dubois Dr
Warsaw, IN 46580
Phone (219) 267-3200

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

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

Hospital & facility affiliations 3

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": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1508594870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843603",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752843603",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10315 DAWSONS CREEK BLVD STE AB",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251912",
            "telephone_number": "260-436-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KYLE",
        "middle_name": "RODNEY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-12",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28232084A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508594870",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.