Laura Pavel Ketelsen, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

128906 Issued in FL

Practice address

5316 Nesconset Hwy
Port Jefferson Station, NY 11776-2591

Phone

(833) 660-7246

NPI assigned

Jan 30, 2020

Last updated

Sep 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, NY2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Parviz Soomekh, MD PCGroup PAC ID 9739464660, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Parviz Soomekh MD PC

  • Anesthesiology Physician
  • Carle Place, NY
  • NPI 1790142677
  Medicare reassignment Care Compare group NPD
• Quality Medical Management Corp

  • Certified Registered Nurse Anesthetist
  • Port Jefferson Station, NY
  • NPI 1114502606

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Associates of New Mexico P C

  • Specialist
  • Albuquerque, NM
  • NPI 1912900754
  Medicare reassignment NPD

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1578194247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SHENANDOAH BLVD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762022",
            "telephone_number": "703-314-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5316 NESCONSET HWY",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762591",
            "telephone_number": "833-660-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETELSEN",
        "first_name": "LAURA",
        "middle_name": "PAVEL",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "128906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth G Rosenthal M.D.PC
• Warren L Kent, DPM
• Frank John Kershis, PT, COMT
• David Kessler
• Howard Kessler, O.D.
• Karin Marie Keyes, LCSW
• Hiba Khan, MA-MFT
• Zarlasht Khan
• Kid Smiles Pediatric Dentistry of Port Jefferson Station PLLC
• Kids First Pediatrics, PC

• Certified Registered Nurse Anesthetist in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Certified Registered Nurse Anesthetist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.