Individual provider Active NPI

Kevin Gadomski, CRNA

  • Certified Registered Nurse Anesthetist
  • Newark, DE
National Provider Identifier
1922018134
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NR08648400 Issued in NJ
Practice address
111 Continental Dr
Suite 412
Newark, DE 19713-4306
Phone
(302) 709-4497
Fax
(302) 733-0854
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 26NR08648400 NJ Primary

Addresses

Primary practice location

111 Continental Dr
Suite 412
Newark, DE 19713-4306

Mailing address

111 Continental Dr
Suite 412
Newark, DE 19713-4306
Phone (302) 709-4497

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041214000237 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961469770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.65 of 100Reported as group
Quality
85.05
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR08648400NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Mid-Atlantic Anesthesia Associates PC Nurse Anesthetist, Certified Registered PastSince Sep 15, 2019 Accepting new patients
Philadelphia Health & Education Corporation Past Accepting new patients
Haverford Anesthesia Associates-NJ, P.C. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922018134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CONTINENTAL DR",
            "address_2": "SUITE 412",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134306",
            "telephone_number": "302-709-4497",
            "fax_number": "302-733-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CONTINENTAL DR",
            "address_2": "SUITE 412",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134306",
            "telephone_number": "302-709-4497",
            "fax_number": "302-733-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADOMSKI",
        "first_name": "KEVIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NR08648400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.