Individual provider Active NPI

Beena Kaithamattom

  • Certified Registered Nurse Anesthetist
  • Kissimmee, FL
National Provider Identifier
1568846723
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP 9308536 Issued in FL
Practice address
700 West Oak Street
Osceola Regional Medical Center
Kissimmee, FL 34741
Phone
(407) 518-3553
NPI assigned
Jul 16, 2015
Last updated
Jul 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 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 ARNP 9308536 FL Primary

Addresses

Primary practice location

700 West Oak Street
Osceola Regional Medical Center
Kissimmee, FL 34741

Mailing address

1613 N Harrison Pky #200
Sunrise, FL 33323

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150819009231 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779898739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

1401 S Seminole Blvd
Sanford, FL 32771-6743
Phone (407) 321-4500

4500 W Newberry Rd
Gainesville, FL 32607-2245
Phone (352) 367-2310

8300 Red Bug Lake Rd
Oviedo, FL 32765-6801
Phone (407) 359-4503

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9308536FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp, Inc. CurrentSince Jul 23, 2015 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 23, 2015 Accepting new patients

Locations

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

2275 N Central Ave
Kissimmee, FL 34741
Phone (407) 570-0573

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

8300 Red Bug Lake Rd
Oviedo, FL 32765
Phone (407) 359-6007

325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

Organizations & group practices 3

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": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1568846723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 N HARRISON PKY #200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "33323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WEST OAK STREET",
            "address_2": "OSCEOLA REGIONAL MEDICAL CENTER",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34741",
            "telephone_number": "407-518-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAITHAMATTOM",
        "first_name": "BEENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP 9308536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.