Individual provider Active NPI

Kelly S Dula, CRNA

  • Certified Registered Nurse Anesthetist
  • Willoughby, OH
National Provider Identifier
1871826735
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.11083 Issued in OH
Practice address
36000 Euclid Ave
Willoughby, OH 44094-4625
Phone
(440) 350-0832
Fax
(440) 579-0191
NPI assigned
Sep 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN304555 OH
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.11083 OH Primary

Addresses

Primary practice location

36000 Euclid Ave
Willoughby, OH 44094-4625

Mailing address

7757 Auburn Rd Ste 15
Painesville, OH 44077-9604
Phone (440) 350-0832

Other practice location 1

7757 Auburn Rd Ste 15
Painesville, OH 44077-9604
Phone (440) 350-0832

Other identifiers 1

IdentifierTypeStateIssuer
3014866MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091021000298 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 1658418892 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

7580 Auburn Rd
Suite 214
Concord Township, OH 44077-9617
Phone (440) 354-0944

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN304555OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Apr 1, 2023 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Apr 1, 2023 Accepting new patients
Ohio Anesthesia Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Apr 17, 2020 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Apr 1, 2023 Accepting new patients

Locations

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

11100 Euclid Ave
Cleveland Heights, OH 44106

7757 Auburn Rd
Ste 15
Concord Township, OH 44077
Phone (440) 709-9150

7590 Auburn Rd
Concord Township, OH 44077
Phone (440) 354-1899

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166

Interoperability endpoints

  • Direct secure messaging: kdula96890@ehrdirect.uhhospitals.org

Organizations & group practices 5

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": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1871826735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7757 AUBURN RD STE 15",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440779604",
            "telephone_number": "440-350-0832",
            "fax_number": "440-354-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 EUCLID AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944625",
            "telephone_number": "440-350-0832",
            "fax_number": "440-579-0191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7757 Auburn Rd Ste 15",
            "address_purpose": "LOCATION",
            "city": "Painesville",
            "state": "OH",
            "postal_code": "440779604",
            "country_code": "US",
            "telephone_number": "440-350-0832",
            "fax_number": "440-354-7420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DULA",
        "first_name": "KELLY",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-10",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN304555",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.11083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3014866",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.