Individual provider Active NPI

Kristine Nikolai, CRNA

  • Certified Registered Nurse Anesthetist
  • Stoughton, WI
National Provider Identifier
1124182613
Registry record updated Aug 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4337500 Issued in WI
Practice address
900 Ridge St
Stoughton, WI 53589-1864
Phone
(608) 873-6611
Fax
(608) 873-2255
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2009

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 4337500 WI Primary

Addresses

Primary practice location

900 Ridge St
Stoughton, WI 53589-1864

Mailing address

900 Ridge St
Stoughton, WI 53589-1864
Phone (608) 873-6611

Other identifiers 2

IdentifierTypeStateIssuer
43330500MedicaidWI
4337500OtherWILICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100224000365 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608920814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stoughton Hospital AssociationGroup PAC ID 7012825706, 66 clinicians

Practice addresses (Care Compare)

900 Ridge St
Stoughton, WI 53589-1864
Phone (608) 873-6611

Hospital & facility affiliations

  • Stoughton Hospital Hospital, Stoughton, WI, CCN 521343

Merit-based Incentive Payment System (MIPS)

Final score
85.73 of 100Reported as group
Quality
87.42
Promoting interoperability
100
Improvement activities
40
Cost
65.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4337500WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Stoughton Hospital Association CurrentSince Feb 9, 1998 Accepting new patients
Stoughton Hospital Association CurrentSince Feb 9, 1998 Accepting new patients

Locations

990 Janesville St
Ste L
Oregon, WI 53575

900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410

Organizations & group practices 2

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.

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1124182613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RIDGE ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891864",
            "telephone_number": "608-873-6611",
            "fax_number": "608-873-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 RIDGE ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891864",
            "telephone_number": "608-873-6611",
            "fax_number": "608-873-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLAI",
        "first_name": "KRISTINE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "4337500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43330500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4337500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; 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.