NPIMap

Organization Active NPI

Paul Kisucky Crna PC

  • Certified Registered Nurse Anesthetist
  • El Paso, TX
National Provider Identifier
1639249196
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
PAUL KISUCKY CRNA PC
Practice address
1416 George Dieter Dr
El Paso, TX 79936-7601
Phone
(915) 252-1654
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Authorized official

Name
Paul Kisucky, CRNA
Title
Owner
Phone
(682) 365-7402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1416 George Dieter Dr
El Paso, TX 79936-7601

Mailing address

PO Box 220717
El Paso, TX 79913-2717
Phone (682) 365-7402

Other identifiers 3

IdentifierTypeStateIssuer
088570902MedicaidTX
00C05VOtherBLUE CROSS BLUE SHIELD
2277986OtherAETNA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1639249196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220717",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799132717",
            "telephone_number": "682-365-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 GEORGE DIETER DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799367601",
            "telephone_number": "915-252-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL KISUCKY CRNA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "KISUCKY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-365-7402",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088570902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00C05V",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2277986",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.