Individual provider Active NPI

William Klemczuk Jr., DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Salem, MA
National Provider Identifier
1134613359
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN2306913 Issued in MA
Practice address
81 Highland Ave
Salem, MA 01970-2768
Phone
(978) 741-1200
NPI assigned
Jun 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2306913 MA
Certified Registered Nurse Anesthetist 367500000X RN2306913 MA Primary

Addresses

Primary practice location

81 Highland Ave
Salem, MA 01970-2768

Mailing address

83 Lynn St
Peabody, MA 01960-5735
Phone (857) 445-6525

Other practice location 1

83 Lynn St
Peabody, MA 01960-5735
Phone (857) 445-6525

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814002542 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183123565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass General Brigham Medical Group, Inc.Group PAC ID 3971987108, 140 clinicians

Practice addresses (Care Compare)

47 Middlesex Tpke
Burlington, MA 01803-4945
Phone (857) 282-8100

81 Highland Ave
Salem, MA 01970-2714
Phone (617) 726-4121

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2306913MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group, Inc. CurrentSince Sep 1, 2025 Accepting new patients

Locations

47 Middlesex Tpke
Burlington, MA 01803
Phone (857) 282-8100

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-2063

Organizations & group practices 1

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 1

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1134613359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 LYNN ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019605735",
            "telephone_number": "857-445-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702768",
            "telephone_number": "978-741-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "83 Lynn St",
            "address_purpose": "LOCATION",
            "city": "Peabody",
            "state": "MA",
            "postal_code": "019605735",
            "country_code": "US",
            "telephone_number": "857-445-6525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEMCZUK",
        "first_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2306913",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2306913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.