Individual provider Active NPI

Seth P Calonder, CRNA

  • Certified Registered Nurse Anesthetist
  • Wausau, WI
National Provider Identifier
1528217130
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
141389030 Issued in WI
Practice address
425 Pine Ridge Boulevard
Suite 211
Wausau, WI 54401
Phone
(715) 845-5505
NPI assigned
Sep 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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 141389030 WI Primary

Addresses

Primary practice location

425 Pine Ridge Boulevard
Suite 211
Wausau, WI 54401

Mailing address

425 Pine Ridge Boulevard
Suite 211
Wausau, WI 54401
Phone (715) 845-5505

Other identifiers 3

IdentifierTypeStateIssuer
213050002OtherMEDICARE - WISCONSIN
44396700MedicaidWI
213050002OtherWIMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081110000431 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870652514 Reassigns benefits to 1 organization

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
Central Wisconsin AnesthesiologyGroup PAC ID 5597667097, 57 clinicians

Practice addresses (Care Compare)

425 Pine Ridge Blvd
Suite 211
Wausau, WI 54401-4123
Phone (715) 845-5505

Hospital & facility affiliations

  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030

Merit-based Incentive Payment System (MIPS)

Final score
79.11 of 100Reported as group
Quality
74.74
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
141389030WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Wisconsin Anesthesiology CurrentSince Sep 8, 2008 Accepting new patients

Locations

425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401
Phone (715) 845-5505

Organizations & group practices 1

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 10

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": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257984000000",
    "number": "1528217130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BOULEVARD",
            "address_2": "SUITE 211",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "telephone_number": "715-845-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BOULEVARD",
            "address_2": "SUITE 211",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "telephone_number": "715-845-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALONDER",
        "first_name": "SETH",
        "middle_name": "P",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2009-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "141389030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - WISCONSIN",
            "identifier": "213050002",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44396700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "213050002",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.