Individual provider Active NPI

John Frederick Kycey, CRNA

  • Certified Registered Nurse Anesthetist
  • Mesa, AZ
National Provider Identifier
1952372328
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN065393 Issued in AZ
Practice address
2434 S Playa
Mesa, AZ 85202-6925
Phone
(480) 730-6329
Fax
(480) 730-0178
NPI assigned
Feb 1, 2006
Last updated
Aug 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP1931182 FL
Certified Registered Nurse Anesthetist 367500000X RN065393 AZ Primary

Addresses

Primary practice location

2434 S Playa
Mesa, AZ 85202-6925

Mailing address

2434 S Playa
Mesa, AZ 85202-6925
Phone (480) 730-6329

Other identifiers 1

IdentifierTypeStateIssuer
305510800MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050201000135 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355391921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantis Medical Group Az PLLCGroup PAC ID 7214168368, 2 clinicians

Practice addresses (Care Compare)

11047 N 19TH Ave
Phoenix, AZ 85029-4816
Phone (602) 589-0500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP1931182FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Squaw Peak Anesthesia Inc Past Accepting new patients
Clinical Partners PA Anesthesiology Past Accepting new patients
Capital City Anesthesia LLC Anesthesiology Past Accepting new patients
Xenon Heath PC Anesthesiology Past Accepting new patients
Integrity Pain and Anesthesia PLLC Anesthesiology Past Accepting new patients
Sun Pain Management, PLLC PastSince Feb 29, 2016 Accepting new patients
Clinical Associates, Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Cactus Valley Anesthesia PLC Nurse Anesthetist, Certified Registered PastSince May 29, 2008 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DJIBDA

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1952372328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2434 S PLAYA",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026925",
            "telephone_number": "480-730-6329",
            "fax_number": "480-730-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 S PLAYA",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026925",
            "telephone_number": "480-730-6329",
            "fax_number": "480-730-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYCEY",
        "first_name": "JOHN",
        "middle_name": "FREDERICK",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP1931182",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "RN065393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305510800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.