Individual provider Active NPI

Lorraine Kennedy, CRNA

  • Certified Registered Nurse Anesthetist
  • Elmhurst, NY
National Provider Identifier
1679502082
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN455481 Issued in NY
Practice address
9002 Queens Blvd
Elmhurst, NY 11373-3730
Phone
(718) 558-1000
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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 RN455481 NY Primary

Addresses

Primary practice location

9002 Queens Blvd
Elmhurst, NY 11373-3730

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040209000727 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123912508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

195 E Main St
Huntington, NY 11743-2957
Phone (914) 666-8866

301 E Main St
Bay Shore, NY 11706-8408
Phone (914) 666-8866

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN455481NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Anesthesiology, PC CurrentSince Nov 1, 2017 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

2001 Marcus Ave
Ste N18
New Hyde Park, NY 11042
Phone (516) 775-7770

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

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 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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1679502082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9002 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733730",
            "telephone_number": "718-558-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "LORRAINE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "RN455481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.