Individual provider Active NPI

Andrea Gundelach, CRNA

  • Certified Registered Nurse Anesthetist
  • Marinette, WI
National Provider Identifier
1336864669
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1101593 Issued in WI
Practice address
3003 University Dr
Marinette, WI 54143-4110
Phone
(715) 735-4200
Fax
(715) 735-8019
NPI assigned
Oct 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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 1101593 WI Primary

Addresses

Primary practice location

3003 University Dr
Marinette, WI 54143-4110

Mailing address

1035 Kepler Dr
Green Bay, WI 54311-8320
Phone (920) 490-9046

Other practice location 1

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (877) 229-0273

Other identifiers 1

IdentifierTypeStateIssuer
100226260MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230215000409 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577935865 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Clinic LLPGroup PAC ID 4385554328, 197 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-8250

Hospital & facility affiliations

  • Aurora Baycare Medical Ctr Hospital, Green Bay, WI, CCN 520193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1101593WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Mar 1, 2023 Accepting new patients
Baycare Clinic LLP CurrentSince Mar 1, 2023 Accepting new patients
Baycare Clinic LLP CurrentSince Mar 1, 2023 Accepting new patients
Baycare Aurora, LLC CurrentSince Mar 1, 2023 Accepting new patients
Aurora Medical Group, Inc. Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2023 Accepting new patients

Locations

1035 Kepler Dr
Green Bay, WI 54311

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

1500 Arbor Way
Kaukauna, WI 54130
Phone (877) 229-2273

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066

Organizations & group practices 5

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1336864669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118320",
            "telephone_number": "920-490-9046",
            "fax_number": "920-405-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 UNIVERSITY DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434110",
            "telephone_number": "715-735-4200",
            "fax_number": "715-735-8019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2845 Greenbrier Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116519",
            "country_code": "US",
            "telephone_number": "877-229-0273",
            "fax_number": "920-288-4863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNDELACH",
        "first_name": "ANDREA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "1101593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100226260",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.