Individual provider Active NPI

Kellen Patrick Schmidt

  • Certified Registered Nurse Anesthetist
  • Watertown, SD
National Provider Identifier
1336810696
Registry record updated Sep 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CR001092 Issued in SD
Practice address
401 9TH Ave NW
Watertown, SD 57201-1548
Phone
(605) 882-7000
NPI assigned
Sep 25, 2021
Last updated
Sep 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2021

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 CR001092 SD Primary

Addresses

Primary practice location

401 9TH Ave NW
Watertown, SD 57201-1548

Mailing address

301 N French Ave
Sioux Falls, SD 57103-1330
Phone (605) 254-1010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211111002574 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042609091 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000

4500 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.59 of 100Reported as group
Quality
100
Promoting interoperability
96
Improvement activities
40
Cost
85.3

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coteau Des Prairies Hospital CurrentSince Sep 27, 2025 Accepting new patients
Ikare Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2024 Accepting new patients
Coteau Des Prairies Hospital CurrentSince Sep 27, 2025 Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince Oct 5, 2021 Accepting new patients
Coteau Des Prairies Hospital CurrentSince Sep 27, 2025 Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince Oct 5, 2021 Accepting new patients

Locations

310 8th Ave NW
Ste 508
Aberdeen, SD 57401

905 N 3rd St
Aberdeen, SD 57401
Phone (605) 226-2108

1201 Mickelson Dr
Watertown, SD 57201
Phone (605) 882-0432

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1632528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632528000000",
    "number": "1336810696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N FRENCH AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571031330",
            "telephone_number": "605-254-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "KELLEN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-25",
        "last_updated": "2021-09-25",
        "certification_date": "2021-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "CR001092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2021; 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.