Individual provider Active NPI

Kenneth Taylor, CRNA

  • Certified Registered Nurse Anesthetist
  • Beverly, MA
National Provider Identifier
1720064538
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN166477 Issued in MA
Practice address
85 Herrick St
Beverly, MA 01915-1790
Phone
(978) 816-3700
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 120904 MA
Certified Registered Nurse Anesthetist 367500000X RN166477 MA Primary

Addresses

Primary practice location

85 Herrick St
Beverly, MA 01915-1790

Mailing address

41 Mall Rd
Burlington, MA 01805-0001

Other practice location 1

75 Lindall St
Hunt Center
Danvers, MA 01923-2121
Phone (978) 774-4400 ext. 2940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120203000369 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375700230 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beth Israel Lahey Health Specialty Care, Inc.Group PAC ID 2365405024, 264 clinicians

Practice addresses (Care Compare)

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8400

480 Maple St
Danvers, MA 01923-4065
Phone (978) 304-8451

85 Herrick St
Beverly, MA 01915-1790
Phone (978) 816-3700

Hospital & facility affiliations

  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120904MAMDClinical Social Worker
RN166477MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Anesthesia Associates, Inc. CurrentSince Dec 1, 1999 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Nov 1, 2023 Accepting new patients

Locations

85 Herrick St
Beverly, MA 01915
Phone (978) 816-3700

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

480 Maple St
Ste C233A
Danvers, MA 01923
Phone (978) 304-8690

75 Lindall St
Danvers, MA 01923
Phone (978) 767-2847

Organizations & group practices 2

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1720064538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790",
            "telephone_number": "978-816-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Lindall St",
            "address_2": "Hunt Center",
            "address_purpose": "LOCATION",
            "city": "Danvers",
            "state": "MA",
            "postal_code": "019232121",
            "country_code": "US",
            "telephone_number": "978-774-4400 x2940",
            "fax_number": "978-777-1462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KENNETH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "120904",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN166477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.