Kevin Sistani, A.A.

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

28513167 Issued in MI

Practice address

100 Michigan St NE
Grand Rapids, MI 49503

Phone

(616) 364-4200

Fax

(616) 364-7347

NPI assigned

Apr 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, DC2 enrollments

Enrollment records 2

Specialty

Anesthesiology Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Anesthesia PLLCGroup PAC ID 0143538769, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Michigan Surgical Hospital LLC Hospital, Warren, MI, CCN 230264

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

State licenses

Practice roles

Locations

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.

• Alliance Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Flint, MI
  • NPI 1063880052
  Medicare reassignment Care Compare group NPD
• Jawad a Shah, MD PC

  • Specialist
  • Flint, MI
  • NPI 1942402391
  Medicare reassignment NPD
• Surgical Anesthesia Associates, PLLC

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1811930647
  Medicare reassignment NPD
• Jawad a Shah MD PC

  • Durable Medical Equipment & Medical Supplies
  • Dearborn, MI
  • NPI 1114667763
  NPD
• Jawad a Shah MD PC

  • Durable Medical Equipment & Medical Supplies
  • Warren, MI
  • NPI 1285374843
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southeast Michigan Surgical Hospital, LLC

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1962402354
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1659834562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259493",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 S New Ballas Rd Dept Of",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418221",
            "country_code": "US",
            "telephone_number": "314-251-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISTANI",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "A.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MI",
            "license": "28513167",
            "primary": true
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Sironen
• Carole Ann Sisco, LPC
• Cheryl A Sisco, NP
• Seth Roy Siskonen
• John Eric Sisson, MD
• Sisu Counseling and Wellness LLC
• Kayla Sitton
• Sreehari Sivasubramanian
• Paige Siver
• Megan E Six, MA, LLMFT

• Anesthesiologist Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Anesthesiologist Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.