Individual provider Active NPI

Katherine Niemczura

  • Certified Registered Nurse Anesthetist
  • Joliet, IL
National Provider Identifier
1649632829
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209012296 Issued in IL
Practice address
1200 Maple Rd
Joliet, IL 60432-1439
Phone
(815) 740-1100
NPI assigned
Mar 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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 209012296 IL Primary

Addresses

Primary practice location

1200 Maple Rd
Joliet, IL 60432-1439

Mailing address

1200 Maple Rd
Joliet, IL 60432-1439

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160331001988 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779880067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Anesthesia Associates P CGroup PAC ID 0042118069, 53 clinicians

Practice addresses (Care Compare)

1200 Maple Rd
Joliet, IL 60432-1439
Phone (815) 740-1100

Hospital & facility affiliations

  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209012296ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Anesthesia Associates, P.C. CurrentSince Feb 28, 2016 Accepting new patients

Locations

403 S Kennedy Dr
Bradley, IL 60915
Phone (815) 928-9999

1200 Maple Rd
Joliet, IL 60432
Phone (815) 740-1100

Organizations & group practices 1

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 2

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": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1649632829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 MAPLE RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604321439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MAPLE RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604321439",
            "telephone_number": "815-740-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMCZURA",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209012296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.