Individual provider Active NPI

Katherine Sara Streidl, CRNA

  • Certified Registered Nurse Anesthetist
  • Warren, MI
National Provider Identifier
1194350645
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704310635 Issued in MI
Practice address
11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone
(586) 573-5000
NPI assigned
Mar 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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 4704310635 MI Primary

Addresses

Primary practice location

11800 E 12 Mile Rd
Warren, MI 48093-3472

Mailing address

1032 N Connecticut Ave
Royal Oak, MI 48067-1403
Phone (231) 327-6294

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200908000945 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991123986 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Mary Mercy Hospital CrnaGroup PAC ID 8820163538, 41 clinicians

Practice addresses (Care Compare)

36475 5 Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-2909

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Macomb-Oakland Hospital Nurse Anesthetist, Certified Registered CurrentSince Aug 2, 2020 Accepting new patients
Henry Ford Health Macomb Oakland Hospital Nurse Anesthetist, Certified Registered CurrentSince Aug 2, 2020 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Aug 2, 2020 Accepting new patients
St Mary Mercy Hospital Crna Nurse Anesthetist, Certified Registered CurrentSince Aug 15, 2021 Accepting new patients

Locations

7924 Solutions Ctr Dr
Chicago, IL 60677

7920 Solutions Ctr Dr
Chicago, IL 60677

350 E Devon Ave
Itasca, IL 60143

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: kstreidl1291274@direct.trinity-health.org

Organizations & group practices 4

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": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1194350645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 N CONNECTICUT AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671403",
            "telephone_number": "231-327-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREIDL",
        "first_name": "KATHERINE",
        "middle_name": "SARA",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704310635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.