Individual provider Active NPI

Nicole Kawa, CRNA

  • Certified Registered Nurse Anesthetist
  • Upland, PA
National Provider Identifier
1891972832
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN560901 Issued in PA
Practice address
30 Medical Center Blvd
Suite 305
Upland, PA 19013
Phone
(610) 874-6448
Fax
(610) 876-7399
NPI assigned
Jan 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN560901 PA Primary

Addresses

Primary practice location

30 Medical Center Blvd
Suite 305
Upland, PA 19013

Mailing address

914 South Avenue
Apt a-15
Secane, PA 19018
Phone (781) 718-9358

Other identifiers 1

IdentifierTypeStateIssuer
RN560901OtherPALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081022000204 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850459777 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Anesthesia, Inc. CurrentSince Jan 14, 2008 Accepting new patients
Associates in Anesthesia Past Accepting new patients

Locations

1212 Baltimore Pike
Ste 200
Chadds Ford, PA 19317
Phone (610) 874-4147

30 Medical Center Blvd
Ste 305
Chester, PA 19013
Phone (610) 619-7411

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1891972832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 SOUTH AVENUE",
            "address_2": "APT A-15",
            "city": "SECANE",
            "state": "PA",
            "postal_code": "19018",
            "telephone_number": "781-718-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEDICAL CENTER BLVD",
            "address_2": "SUITE 305",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "19013",
            "telephone_number": "610-874-6448",
            "fax_number": "610-876-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWA",
        "first_name": "NICOLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN560901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN560901",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.