Individual provider Active NPI

Kathleen M Martin, CRNA

  • Certified Registered Nurse Anesthetist
  • Syracuse, NY
National Provider Identifier
1740444801
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
288120-1 Issued in NY
Practice address
301 Prospect Ave
Anesthesia Group PC
Syracuse, NY 13203-1807
Phone
(315) 448-5440
Fax
(315) 472-5010
NPI assigned
Jul 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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 288120-1 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Anesthesia Group PC
Syracuse, NY 13203-1807

Mailing address

301 Prospect Ave
Anesthesia Group PC
Syracuse, NY 13203-1807
Phone (315) 448-5440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
288120-1NYMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1740444801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "address_2": "ANESTHESIA GROUP PC",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5440",
            "fax_number": "315-472-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "address_2": "ANESTHESIA GROUP PC",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5440",
            "fax_number": "315-472-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "288120-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.