| Kerry Ana Vittum, CRNA | |
|
55 Fogg Rd, South Weymouth, MA 02190 | |
| (781) 624-8000 | |
| Not Available |
| Full Name | Kerry Ana Vittum |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 7 Years |
| Location | 55 Fogg Rd, South Weymouth, Massachusetts |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235663089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN268888 (Massachusetts) | Primary |
| 163W00000X | Registered Nurse | RN268888 (Massachusetts) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| South Shore Hospital | South weymouth, MA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Coastal Medical Associates | 7113029257 | 412 |
| South Suburban Gastroenterology Pc | 9931194412 | 36 |
| Entity Name | South Suburban Gastroenterology Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114948478 PECOS PAC ID: 9931194412 Enrollment ID: O20040415000288 |
| Entity Name | Coastal Medical Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932175684 PECOS PAC ID: 7113029257 Enrollment ID: O20070221000057 |
| Mailing Address | Practice Location Address |
|---|---|
| Kerry Ana Vittum, CRNA 163 Libbey Pkwy Ste 301, Weymouth, MA 02189-3118 Ph: (781) 337-4224 | Kerry Ana Vittum, CRNA 55 Fogg Rd, South Weymouth, MA 02190 Ph: (781) 624-8000 |
Tara Marie Steele, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 55 Fogg Rd, South Weymouth, MA 02190 Phone: 781-624-8000 | |
Julia Mancuso, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 55 Fogg Rd, South Weymouth, MA 02190 Phone: 781-624-8000 | |
Mckenzie Louis Samuelson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 55 Fogg Rd, South Weymouth, MA 02190 Phone: 781-624-8000 |