Individual provider Active NPI

Kyle Joseph Manthei, DNP, CRNA, BSN, RN

  • Certified Registered Nurse Anesthetist
  • Lapeer, MI
National Provider Identifier
1740802974
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704362710 Issued in MI
Practice address
1375 N Main St
Lapeer, MI 48446-1350
Phone
(810) 667-5500
Fax
(810) 667-5790
NPI assigned
May 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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 105909 WV
Certified Registered Nurse Anesthetist 367500000X 4704362710 MI Primary

Addresses

Primary practice location

1375 N Main St
Lapeer, MI 48446-1350

Mailing address

4055 Harbor Point Dr
Norton Shores, MI 49441-4662
Phone (810) 358-9364

Other practice location 1

812 Gorman Ave
Elkins, WV 26241-3181
Phone (304) 636-3300

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.davishealthsystem.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, MI, OH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200519001011 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113358565 Reassigns benefits to 1 organization
I20230227000812 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113358565 Reassigns benefits to 3 organizations
I20250219001781 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113358565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Clinical Colleagues IncGroup PAC ID 8729011333, 170 clinicians
Monaco Management LLCGroup PAC ID 9739577461, 37 clinicians

Practice addresses (Care Compare)

1400 W Main St
Anesthesiology Department
Bellevue, OH 44811-9088
Phone (419) 483-4040

300 E Warwick Dr
Alma, MI 48801-1014
Phone (989) 463-1101

Hospital & facility affiliations

  • Bellevue Hospital Hospital, Bellevue, OH, CCN 360107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Certified Registered Nurse, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered CurrentSince Oct 13, 2023 Accepting new patients
Clinical Colleagues Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 10, 2024 Accepting new patients
Davis Memorial Hospital CurrentSince May 26, 2020 Accepting new patients
Monaco Management, LLC Nurse Anesthetist, Certified Registered CurrentSince May 17, 2023 Accepting new patients
Davis Memorial Hospital CurrentSince May 26, 2020 Accepting new patients

Locations

300 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0104

1707 Lake Lansing Rd
Lansing, MI 48912
Phone (517) 267-0033

3400 E Jolly Rd
Lansing, MI 48910
Phone (517) 272-1063

3663 N Country Dr
Traverse City, MI 49684
Phone (231) 252-1228

135 S Prospect St
Ypsilanti, MI 48198
Phone (734) 547-1060

1400 W Main St
Bellevue, OH 44811
Phone (330) 563-0641

1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077

812 Gorman Ave
Elkins, WV 26241
Phone (304) 636-3300

Organizations & group practices 6

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": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1740802974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 HARBOR POINT DR",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494414662",
            "telephone_number": "810-358-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 N MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461350",
            "telephone_number": "810-667-5500",
            "fax_number": "810-667-5790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 Gorman Ave",
            "address_purpose": "LOCATION",
            "city": "Elkins",
            "state": "WV",
            "postal_code": "262413181",
            "country_code": "US",
            "telephone_number": "304-636-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTHEI",
        "first_name": "KYLE",
        "middle_name": "JOSEPH",
        "credential": "DNP, CRNA, BSN, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-11",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "105909",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704362710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.davishealthsystem.org",
            "affiliation": "N",
            "address_1": "812 Gorman Ave",
            "city": "Elkins",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262413181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.