Individual provider Active NPI

Kaitlyn M Siesel

  • Certified Registered Nurse Anesthetist
  • Greeley, CO
National Provider Identifier
1356899389
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN.0993218-CRNA Issued in CO
Practice address
1801 16TH Street
Greeley, CO 80631
Phone
(970) 810-4121
Fax
(770) 701-6675
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 111936 OH
Certified Registered Nurse Anesthetist 367500000X 111936 CA
Certified Registered Nurse Anesthetist 367500000X APN.0993218-CRNA CO Primary

Addresses

Primary practice location

1801 16TH Street
Greeley, CO 80631

Mailing address

PO Box 1786
Fort Collins, CO 80522-1786
Phone (855) 654-5262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171214000900 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133408131 Reassigns benefits to 1 organization
I20201028000616 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133408131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Anesthesia and Pain Services LLCGroup PAC ID 8022245372, 217 clinicians

Practice addresses (Care Compare)

195 Wadsworth Rd
Wadsworth, OH 44281-9537
Phone (330) 331-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
111936CAMDClinical Social Worker
95000626CAMDFamily Nurse Practitioner
APN.0993218-CRNACOMDCertified Registered Nurse Anesthetist
111936OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain State Anesthesia Providers CurrentSince Nov 1, 2019 Accepting new patients
Rocky Mountain State Anesthesia Providers CurrentSince Nov 1, 2019 Accepting new patients
Dayton Anesthesia & Pain Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 14, 2020 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince May 4, 2023 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince May 4, 2023 Accepting new patients

Locations

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

7111 Fairway Dr
Ste 450
Palm Beach Gardens, FL 33418
Phone (561) 623-2035

444 N Main St
Akron, OH 44310
Phone (330) 375-6363

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

3000 Hospital Dr
Batavia, OH 45103
Phone (513) 557-3209

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

195 Wadsworth Rd
Wadsworth, OH 44281
Phone (330) 331-1000

265 Brookview Centre Way
Ste 400
Knoxville, TN 37919
Phone (865) 293-5549

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 3

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": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1356899389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1786",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805221786",
            "telephone_number": "855-654-5262",
            "fax_number": "770-701-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 16TH STREET",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80631",
            "telephone_number": "970-810-4121",
            "fax_number": "770-701-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIESEL",
        "first_name": "KAITLYN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "111936",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "111936",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "APN.0993218-CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.