Active NPI
Siarhei Mikhailouski, CRNA
- Certified Registered Nurse Anesthetist
- Utica, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 638247
- Practice address
- 111 Hospital Dr
Utica, NY 13502-2517 - Phone
- (315) 917-7263
- NPI assigned
- Jul 13, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN724693 | PA | |
| Certified Registered Nurse Anesthetist | 367500000X | 638247 | NY | Primary |
Addresses
Primary practice location
111 Hospital Dr
Utica, NY 13502-2517
Mailing address
111 Hospital Dr.
Attn: Credentialing
Utica, NY 13502
Phone (315) 801-8488
Other practice location 1
201 State St Erie
Erie, PA 16550-0001
Phone (315) 725-4186
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN724693 | Other | PA | PA RN LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 624-6000
1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 625-6000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.28 of 100
- Quality
- 75.06
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 69.26
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN724693 | PA | MD | Registered Nurse |
| 638247 | NY | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MVHS Inc | Current | Accepting new patients | |
| MVHS Inc | Single Specialty | Current | Accepting new patients |
Locations
1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222
2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282
1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567
111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534
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.
-
dba Mohawk Valley Health System Inc
- Family Medicine Physician
- Utica, NY
- NPI 1770690737
Single Specialty
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": "1626134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1275105819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 HOSPITAL DR.",
"address_2": "ATTN: CREDENTIALING",
"city": "UTICA",
"state": "NY",
"postal_code": "13502",
"telephone_number": "315-801-8488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 HOSPITAL DR",
"city": "UTICA",
"state": "NY",
"postal_code": "135022517",
"telephone_number": "315-917-7263"
}
],
"practiceLocations": [
{
"address_1": "201 State St Erie",
"address_purpose": "LOCATION",
"city": "Erie",
"state": "PA",
"postal_code": "165500001",
"country_code": "US",
"telephone_number": "315-725-4186",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIKHAILOUSKI",
"first_name": "SIARHEI",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-13",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN724693",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NY",
"license": "638247",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA RN LICENSE",
"identifier": "RN724693",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.