Kathleen Lyn Peck, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

059649-23 Issued in NH

Practice address

333 Borthwick Ave
Portsmouth, NH 03801-7128

Phone

(603) 433-4045

Fax

(603) 559-4123

NPI assigned

Jul 8, 2019

Last updated

Jul 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathleen Lyn Deteso Former name

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portsmouth Anesthesia Associates PAGroup PAC ID 6002855327, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Portsmouth Regional Hospital Hospital, Portsmouth, NH, CCN 300029

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Portsmouth Anesthesia Associates PA

  • Anesthesiology Physician
  • Portsmouth, NH
  • NPI 1568584290
  Medicare reassignment Care Compare group NPD
• Stratham Anesthesia Associates PLLC

  • Anesthesiology Physician
  • Stratham, NH
  • NPI 1346480639
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HCA Health Services of New Hampshire Inc

  dba Portsmouth Regional Hospital

  • General Acute Care Hospital
  • Portsmouth, NH
  • NPI 1518913607
  Care Compare affiliation

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1871155119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 BITTERSWEET LN",
            "city": "STRATHAM",
            "state": "NH",
            "postal_code": "038852565",
            "telephone_number": "603-957-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 BORTHWICK AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017128",
            "telephone_number": "603-433-4045",
            "fax_number": "603-559-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "KATHLEEN",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "059649-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "DETESO",
            "middle_name": "LYN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peak Healthcare at Portsmouth LLC
• Peak Healthcare at Portsmouth LLC
• Eileen Peard
• Karen M. Pearson, ED.D.
• Hannah Peavey, APRN
• Pediatric Associates of Hampton & Portsmouth PC
• Pediatric Associates of Hampton & Portsmouth, P.C.
• Syed M Peeran, MD
• Ilana Peet
• Victoria Pekarski

• Certified Registered Nurse Anesthetist in Portsmouth, NH
• Providers in Portsmouth, NH by specialty
• Certified Registered Nurse Anesthetist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.