Individual provider Active NPI

Kiersten Ashleigh De la Vega, RN

  • Certified Registered Nurse Anesthetist
  • Davie, FL
National Provider Identifier
1922679554
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11024128 Issued in FL
Practice address
10325 SW 20TH St
Davie, FL 33324-7428
Phone
(954) 474-5577
NPI assigned
Jul 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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 RN9439898 FL
Certified Registered Nurse Anesthetist 367500000X APRN11024128 FL Primary

Addresses

Primary practice location

10325 SW 20TH St
Davie, FL 33324-7428

Mailing address

10325 SW 20TH St
Davie, FL 33324-7428

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230419002631 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385009679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf-to-Bay Anesthesiology Associates LLCGroup PAC ID 5092628156, 330 clinicians

Practice addresses (Care Compare)

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-4396

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9439898FLMDRegistered Nurse
APRN11024128FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Feb 10, 2025 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Feb 10, 2025 Accepting new patients
Anesco North Broward LLC CurrentSince Jan 31, 2023 Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

3601 W Commercial Blvd
Ste 5
Ft Lauderdale, FL 33309
Phone (954) 485-2002

3601 W Commercial Blvd
Ste 4
Ft Lauderdale, FL 33309

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

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.

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": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1922679554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10325 SW 20TH ST",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333247428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10325 SW 20TH ST",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333247428",
            "telephone_number": "954-474-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA VEGA",
        "first_name": "KIERSTEN",
        "middle_name": "ASHLEIGH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9439898",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11024128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.