Individual provider Active NPI

Michael Jon Kirwan, CRNA

  • Certified Registered Nurse Anesthetist
  • Blair, NE
National Provider Identifier
1316931074
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
100955 Issued in NE
Practice address
810 North 22ND Street
Blair, NE 68008-1128
Phone
(402) 426-2182
Fax
(402) 426-1297
NPI assigned
Sep 8, 2005
Last updated
Jan 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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 100955 NE Primary

Addresses

Primary practice location

810 North 22ND Street
Blair, NE 68008-1128

Mailing address

20803 Hemlock St
Elkhorn, NE 68022-5119
Phone (402) 380-0869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120504000114 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082876255 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Gastrointestinal Associates PCGroup PAC ID 3779575766, 54 clinicians
Leighow Anesthesia and Medical Aesthetics LLCGroup PAC ID 5597086744, 14 clinicians

Practice addresses (Care Compare)

8901 Indian Hills Dr
Suite 200
Omaha, NE 68114-4032
Phone (402) 397-7057

9850 Nicholas St
Suite 100
Omaha, NE 68114-2191
Phone (402) 343-1122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100955NEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Gastrointestinal Associates PC Nurse Anesthetist, Certified Registered CurrentSince Mar 24, 2017 Accepting new patients
Leighow Anesthesia & Medical Aesthetics LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2018 Accepting new patients
Metro Omaha Anesthesia PC CurrentSince Apr 17, 2018 Accepting new patients

Locations

812 N 22nd St
Blair, NE 68008
Phone (402) 426-4611

2727 N Clarkson St
Fremont, NE 68025
Phone (402) 727-8500

11606 Nicholas St
Omaha, NE 68154
Phone (402) 493-2020

11704 W Center Rd
Ste 110
Omaha, NE 68144
Phone (402) 212-0847

11819 Miracle Hills Dr
Ste 201
Omaha, NE 68154
Phone (402) 884-2450

17001 Lakeside Hills Plz
Ste 200
Omaha, NE 68130
Phone (402) 885-8700

3201 S 24th St
Omaha, NE 68108
Phone (402) 345-9132

4909 S 118th St
Omaha, NE 68137
Phone (402) 397-2010

8901 Indian Hills Dr
Ste 200
Omaha, NE 68114
Phone (402) 397-7057

9850 Nicholas St
Omaha, NE 68114
Phone (402) 343-1122

9850 Nicholas St
Ste 100
Omaha, NE 68114
Phone (402) 343-1122

535 Fortune Dr
Ste 200
Papillion, NE 68046
Phone (402) 934-8040

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1316931074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20803 HEMLOCK ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680225119",
            "telephone_number": "402-380-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 NORTH 22ND STREET",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081128",
            "telephone_number": "402-426-2182",
            "fax_number": "402-426-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRWAN",
        "first_name": "MICHAEL",
        "middle_name": "JON",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "100955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blair, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.