Individual provider Active NPI

Kanchana Liczkowski, CRNA

  • Certified Registered Nurse Anesthetist
  • Naples, FL
National Provider Identifier
1982685145
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9191882 Issued in FL
Practice address
1336 Creekside Blvd
Suite 1
Naples, FL 34108
Phone
(239) 261-1158
Fax
(239) 261-4232
NPI assigned
Nov 7, 2005
Last updated
Dec 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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 124368 MO
Certified Registered Nurse Anesthetist 367500000X ARNP9191882 FL Primary

Addresses

Primary practice location

1336 Creekside Blvd
Suite 1
Naples, FL 34108

Mailing address

1336 Creekside Blvd
Suite 1
Naples, FL 34108
Phone (239) 261-1158

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061215000162 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981505997 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9191882FLMDCertified Registered Nurse Anesthetist
124368MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd, Inc CurrentSince Jul 21, 2023 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Nov 1, 2017 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Nov 1, 2017 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince May 16, 2024 Accepting new patients
SWF Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince May 8, 2021 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Current Accepting new patients
Nchmd Inc Current Accepting new patients
Landmark Hospital of Southwest Florida, LLC CurrentSince Jul 21, 2023 Accepting new patients
West Florida Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Anesthesia Partners, LTD. Past Accepting new patients
Specialists in Anesthesia PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Spartan Anesthesia Associates PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Forest Park Anesthesia, Inc Past Accepting new patients

Locations

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

625 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 574-4600

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

3650 NW 82nd Ave
Ste 101
Doral, FL 33166
Phone (305) 341-7280

12631 Whitehall Dr
Ste 340
Fort Myers, FL 33907

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

63 Barkley Cir
Ste 104
Fort Myers, FL 33907
Phone (239) 275-8452

8380 Riverwalk Park Blvd
Ste 220
Fort Myers, FL 33919
Phone (239) 215-4104

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

1285 Creekside Blvd E
Unit 102
Naples, FL 34109
Phone (239) 624-0310

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

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

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1982685145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 CREEKSIDE BLVD",
            "address_2": "SUITE 1",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34108",
            "telephone_number": "239-261-1158",
            "fax_number": "239-261-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 CREEKSIDE BLVD",
            "address_2": "SUITE 1",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34108",
            "telephone_number": "239-261-1158",
            "fax_number": "239-261-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICZKOWSKI",
        "first_name": "KANCHANA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "124368",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9191882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.