Individual provider Active NPI

Christina Kwiatkowski, CRNA

  • Certified Registered Nurse Anesthetist
  • Toledo, OH
National Provider Identifier
1972960466
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA 18630-NA Issued in OH
Practice address
2642 Wesleyan Drive
Toledo, OH 43614
Phone
(419) 377-5266
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN370771 OH
Registered Nurse 163W00000X 28213402A IN
Certified Registered Nurse Anesthetist 367500000X COA 18630-NA OH Primary

Addresses

Primary practice location

2642 Wesleyan Drive
Toledo, OH 43614

Mailing address

2642 Wesleyan Dr
Toledo, OH 43614-4160
Phone (419) 377-5266

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckwiatkowski110716@epicdirect.promedica.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160317001546 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466758453 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2801 Bay Park Dr
Oregon, OH 43616-4920
Phone (419) 690-7709

Hospital & facility affiliations

  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28213402AINMDRegistered Nurse
RN370771OHMDRegistered Nurse
COA 18630-NAOHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Aug 1, 2017 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Feb 3, 2016 Accepting new patients
Promedica Central Physicians CurrentSince Aug 1, 2017 Accepting new patients

Locations

501 Van Buren St
Fostoria, OH 44830
Phone (419) 435-7734

2801 Bay Park Dr
Oregon, OH 43616
Phone (419) 690-7652

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Organizations & group practices 3

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": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1972960466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2642 WESLEYAN DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436144160",
            "telephone_number": "419-377-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2642 WESLEYAN DRIVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43614",
            "telephone_number": "419-377-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWIATKOWSKI",
        "first_name": "CHRISTINA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN370771",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28213402A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA 18630-NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckwiatkowski110716@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.