Individual provider Active NPI

Walter J Kielkowski, CRNA

  • Certified Registered Nurse Anesthetist
  • Morgantown, WV
National Provider Identifier
1053370197
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
63814 Issued in WV
Practice address
101 Stadium Dr
Morgantown, WV 26506-7911
Phone
(304) 598-4000
Fax
(304) 293-6963
NPI assigned
Mar 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 63814 WV Primary

Addresses

Primary practice location

101 Stadium Dr
Morgantown, WV 26506-7911

Mailing address

PO Box 897
Morgantown, WV 26507-0897
Phone (304) 293-7401

Other identifiers 1

IdentifierTypeStateIssuer
2603458000MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040712001479 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961480207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43370FLMDEmergency Medicine Physician
63814WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince May 28, 2004 Accepting new patients
West Virginia University Medical Corporation CurrentSince May 28, 2004 Accepting new patients
Michael E Donohoe Crna Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Florida Hospital Ocala Inc Past Accepting new patients
Ocala Regional Medical Center Anesthesia Inc Past Accepting new patients
Ocala Surgical Center Anesthesia Inc Past Accepting new patients
Sacher Anesthesia and Pain Management Inc Past Accepting new patients
Lake County Anesthesia Associates PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

801 Harrison Ave
Elkins, WV 26241
Phone (304) 637-3640

1200 J D Anderson Dr
Morgantown, WV 26505
Phone (304) 598-1460

1 Medical Center Dr
Bsmt
Morgantown, WV 26506
Phone (304) 293-7521

1160 Van Voorhis Rd
Morgantown, WV 26505
Phone (304) 598-1100

930 Chestnut Ridge Rd
Morgantown, WV 26505
Phone (304) 293-5299

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1053370197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 897",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070897",
            "telephone_number": "304-293-7401",
            "fax_number": "304-293-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 STADIUM DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265067911",
            "telephone_number": "304-598-4000",
            "fax_number": "304-293-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELKOWSKI",
        "first_name": "WALTER",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "63814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2603458000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.