Individual provider Active NPI

Kevin James Stein, CRNA

  • Certified Registered Nurse Anesthetist
  • Belleville, IL
National Provider Identifier
1457586455
Registry record updated Mar 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209007464 Issued in IL
Practice address
4500 Memorial Dr
Belleville, IL 62226-5360
Phone
(618) 960-1185
NPI assigned
May 19, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2014001570 MO
Certified Registered Nurse Anesthetist 367500000X 209007464 IL Primary

Addresses

Primary practice location

4500 Memorial Dr
Belleville, IL 62226-5360

Mailing address

116 Starlight Dr
Belleville, IL 62226-4929

Other identifiers 1

IdentifierTypeStateIssuer
209007464MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100326000983 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345376570 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Starlight Anesthesia, LLCGroup PAC ID 4082083134, 3 clinicians

Practice addresses (Care Compare)

1200 E Tremont St
Hillsboro, IL 62049-1912
Phone (217) 532-6111

Hospital & facility affiliations

  • Hillsboro Area Hospital Hospital, Hillsboro, IL, CCN 141332

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bel Clair Ambulatory Surgical Treatment Center, LTD. CurrentSince Jul 1, 2014 Accepting new patients
Lawrence County Memorial Hospital Current Accepting new patients
Carlinville Area Hospital Association CurrentSince Aug 1, 2024 Accepting new patients
Associated Pathologists, LLC Current Accepting new patients
Carlinville Area Hospital Association CurrentSince Aug 1, 2024 Accepting new patients
Hillsboro Area Hospital, Inc. Current Accepting new patients
Anesthesia of Southern Illinois LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 27, 2019 Accepting new patients
Evolutionary Healthcare, PLLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Lawrence County Memorial Hospital Current Accepting new patients
Lawrence County Memorial Hospital CurrentSince Aug 1, 2024 Accepting new patients
Starlight Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Carlinville Area Hospital Association Current Accepting new patients

Locations

325 W Lincoln St
Belleville, IL 62220
Phone (618) 225-2299

2810 Frank Scott Pkwy W
Ste 716
Belleville, IL 62223
Phone (618) 355-0880

20733 N Broad St
Carlinville, IL 62626
Phone (217) 854-3141

1200 E Tremont St
Hillsboro, IL 62049
Phone (217) 532-4154

2200 State St
Lawrenceville, IL 62439
Phone (618) 943-1000

1028 S Kirkwood Rd
Saint Louis, MO 63122
Phone (314) 394-2255

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/carlin-6115abf3

Organizations & group practices 12

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 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": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615075200000",
    "number": "1457586455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 STARLIGHT DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622264929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-960-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-19",
        "last_updated": "2021-03-07",
        "certification_date": "2021-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2014001570",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209007464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209007464",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.