Individual provider Active NPI

Gordon Kalo, CRNA

  • Certified Registered Nurse Anesthetist
  • Tawas City, MI
National Provider Identifier
1063496867
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704120512 Issued in MI
Practice address
200 Hemlock St
Tawas City, MI 48763-9237
Phone
(989) 362-0153
Fax
(989) 362-4683
NPI assigned
Dec 5, 2005
Last updated
Jul 13, 2026By the provider in NPPES
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 4704120512 MI Primary

Addresses

Primary practice location

200 Hemlock St
Tawas City, MI 48763-9237

Mailing address

2393 Schust Rd
Saginaw, MI 48603-1334
Phone (989) 793-2820

Other identifiers 2

IdentifierTypeStateIssuer
4096233MedicaidMI
C56007027MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100607000638 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042340762 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center AlpenaGroup PAC ID 8527969922, 97 clinicians

Practice addresses (Care Compare)

1501 W Chisholm St
Alpena, MI 49707-1401
Phone (989) 356-7390

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Apr 16, 2018 Accepting new patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered CurrentSince Jan 18, 2014 Accepting new patients
Mymichigan Medical Center Alpena Current Accepting new patients
Joseph a. Houle MD PC Current Accepting new patients
Mymichigan Medical Center Alpena Nurse Anesthetist, Certified Registered CurrentSince Sep 7, 2021 Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Sep 7, 2021 Accepting new patients
Jon M Kaliszewski MD PC Past Accepting new patients
Covenant Medical Center, Inc Past Accepting new patients
Saginaw Valley Neurosurgery, P.L.L.C. Past Accepting new patients
Mymichigan Medical Center Tawas Past Accepting new patients

Locations

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

748 S Main St
Cheboygan, MI 49721
Phone (231) 627-5601

1707 Lake Lansing Rd
Lansing, MI 48912
Phone (517) 267-0033

3400 E Jolly Rd
Lansing, MI 48910
Phone (517) 272-1063

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

26750 Providence Pkwy
Ste 100
Novi, MI 48374
Phone (248) 662-1500

2393 Schust Rd
Saginaw, MI 48603
Phone (989) 793-2820

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063496867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2393 SCHUST RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031334",
            "telephone_number": "989-793-2820",
            "fax_number": "989-755-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEMLOCK ST",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639237",
            "telephone_number": "989-362-0153",
            "fax_number": "989-362-4683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALO",
        "first_name": "GORDON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704120512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4096233",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C56007027",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tawas City, MI

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.