Individual provider Active NPI

Conrad Kieliszek, CAA

  • Anesthesiologist Assistant
  • Miami, FL
National Provider Identifier
1740709088
Registry record updated Sep 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
8900 N Kendall Dr
Miami, FL 33176-2118
Phone
(786) 596-3621
NPI assigned
Sep 19, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

8900 N Kendall Dr
Miami, FL 33176-2118

Mailing address

12323 Orange Grove Blvd
West Palm Beach, FL 33411-8982
Phone (561) 389-3396

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180423002779 FL Practitioner - Anesthesiology Assistant 9638432743 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

13001 Southern Blvd
Loxahatchee, FL 33470-9203
Phone (561) 798-3300

Hospital & facility affiliations

  • HCA Florida Palms West Hospital Hospital, Loxahatchee, FL, CCN 100269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Bethesda Anesthesia Associates, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Anesthesiologists of Greater Orlando Inc Anesthesiologist Assistant CurrentSince Jul 1, 2021 Accepting new patients
Bethesda Anesthesia Associates, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Sheridan Healthcorp Inc CurrentSince Apr 1, 2021 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Apr 1, 2021 Accepting new patients
Sheridan Healthcorp Inc Current Accepting new patients
Anesthesiologists of Greater Orlando Inc CurrentSince Jul 1, 2021 Accepting new patients

Locations

10301 Hagen Ranch Rd
Ste 520
Boynton Beach, FL 33437
Phone (561) 374-5550

12961 Palms West Dr
Loxahatchee, FL 33470
Phone (561) 793-0437

83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Organizations & group practices 7

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": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505779200000",
    "number": "1740709088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12323 ORANGE GROVE BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334118982",
            "telephone_number": "561-389-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 N KENDALL DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762118",
            "telephone_number": "786-596-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELISZEK",
        "first_name": "CONRAD",
        "name_prefix": "Mr.",
        "credential": "CAA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-19",
        "last_updated": "2017-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; 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.