Individual provider Active NPI

Kathleen Marty Yu, CRNA

  • Certified Registered Nurse Anesthetist
  • Suffern, NY
National Provider Identifier
1891118709
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
582941 Issued in NY
Practice address
255 Lafayette Ave
Suffern, NY 10901-4812
Phone
(845) 368-5039
Fax
(845) 368-5327
NPI assigned
Jan 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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 58294-1 NY
Certified Registered Nurse Anesthetist 367500000X 582941 NY Primary

Addresses

Primary practice location

255 Lafayette Ave
Suffern, NY 10901-4812

Mailing address

233 Lafayette Ave Ste 204
Suffern, NY 10901-5620
Phone (845) 357-5775

Other practice location 1

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4316

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170213001882 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264715408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ramapo Anesthesiologists, PCGroup PAC ID 3476444373, 78 clinicians

Practice addresses (Care Compare)

255 Lafayette Ave
Suffern, NY 10901-4812
Phone (845) 357-5775

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58294-1NYMDRegistered Nurse
582941NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ramapo Valley Anesthesia Associates, LLC CurrentSince Aug 14, 2022 Accepting new patients
Ramapo Anesthesiologists, PC CurrentSince Oct 3, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Jan 7, 2017 Accepting new patients
Montefiore Medical Center CurrentSince Jan 7, 2017 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

974 Route 45
Ste 2000
Pomona, NY 10970
Phone (845) 354-3700

233 Lafayette Ave
Ste 204
Suffern, NY 10901

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

233 Lafayette Ave
Ste LL5
Suffern, NY 10901
Phone (914) 794-7741

Organizations & group practices 4

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.

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": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1891118709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 LAFAYETTE AVE STE 204",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015620",
            "telephone_number": "845-357-5775",
            "fax_number": "845-357-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LAFAYETTE AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014812",
            "telephone_number": "845-368-5039",
            "fax_number": "845-368-5327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTY YU",
        "first_name": "KATHLEEN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "58294-1",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "582941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.