Individual provider Active NPI

Kelsey Leveille

  • Certified Registered Nurse Anesthetist
  • Southfield, MI
National Provider Identifier
1417599150
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704351277 Issued in MI
Practice address
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone
(248) 849-3000
NPI assigned
Oct 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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 4704351277 MI Primary

Addresses

Primary practice location

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (800) 516-5315

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191216000085 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779916259 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians

Practice addresses (Care Compare)

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

Hospital & facility affiliations

  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704351277MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Providence Hospital CurrentSince Mar 23, 2025 Accepting new patients
Henry Ford Health Providence Hospital Nurse Anesthetist, Certified Registered CurrentSince Mar 23, 2025 Accepting new patients
PSJ Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Nov 2, 2019 Accepting new patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 5, 2020 Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

30400 Telegraph Rd
Ste 405
Bingham Farms, MI 48025
Phone (248) 483-8138

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

Interoperability endpoints

  • Direct secure messaging: kleveille1139147@direct.hfhs.org

Organizations & group practices 4

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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1417599150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "800-516-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVEILLE",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704351277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.