Kim A Vazquez, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

463192-1 Issued in NY

Practice address

310 E 14TH Street
My Eye & Ear Infirmary
New York, NY 10003

Phone

(212) 979-4464

NPI assigned

Aug 25, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kim Shannon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Parkway Anesthesia Associates LLC

  • Anesthesiology Physician
  • North Bergen, NJ
  • NPI 1518319755
  NPD
• Rwjbh Observation Associates LLC

  • Emergency Medicine Physician
  • Livingston, NJ
  • NPI 1760095806
  NPD

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1821081746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CATHARINE STREET, P.O. BOX 550",
            "address_2": "EAST MANHATTAN ANESTHESIA PARTNERS, LLC",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12602",
            "telephone_number": "866-868-8415",
            "fax_number": "845-790-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E 14TH STREET",
            "address_2": "MY EYE & EAR INFIRMARY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-979-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "KIM",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-25",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "463192",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "463192-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "SHANNON",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dan L Vazquez, LMSW
• Deborah Vazquez, MSED
• Genevieve Vazquez, MA
• Iris Karina Vazquez, DNP
• Italiz Vazquez
• Madeline Vazquez, M.D.
• Marisol Vazquez
• Mya Leilani Vazquez
• Nicholas Vazquez, MD
• Olga Vazquez, LCSW CASAC

• Certified Registered Nurse Anesthetist in New York, NY
• Providers in New York, NY by specialty
• Certified Registered Nurse Anesthetist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.