Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin Djatcha

Individual provider Certified Registered Nurse Anesthetist · NPI 1790521425

Kevin Djatcha is a Certified Registered Nurse Anesthetist (CRNA) in Providence, Rhode Island. Qualified in 2024, 2 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group and accepts Medicare assignment. Licensed in New Hampshire and Rhode Island.

Years since qualifying
2
Licensed in
NH, RI
In the registry since
2024
Specialties on file
3
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Practice location Address checks out

825 Chalkstone Ave
Providence, RI 02908-4728
Phone: (401) 456-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence APRN04818 (RI)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 112573-23 (NH)
Registered Nurse Taxonomy 163W00000X · Licence 112573-21 (NH)

Record details

NPI number1790521425
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 2, 2024
Last updated in NPPESJanuary 5, 2026
Certification dateJanuary 5, 2026
Mailing address825 Chalkstone Ave, Providence, RI 02908-4728

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Providence