Individual provider Active NPI

Karl J Klotzbuecher, CRNA

  • Certified Registered Nurse Anesthetist
  • Sheboygan, WI
National Provider Identifier
1780791210
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
76954-030 Issued in WI
Doing business as
Karl Joseph Klotzbuecher
Practice address
3400 Union Ave
Sheboygan, WI 53081-8426
Phone
(920) 802-2100
Fax
(920) 802-1500
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 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 569-033 WI
Certified Registered Nurse Anesthetist 367500000X 76954-030 WI Primary

Addresses

Primary practice location

3400 Union Ave
Sheboygan, WI 53081-8426

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other identifiers 1

IdentifierTypeStateIssuer
43298700MedicaidWI

Other names 1

  • Karl Joseph Klotzbuecher Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kklotzbuecher45012@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040416000277 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133114598 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
569-033WIMDCertified Registered Nurse Anesthetist
76954-030WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc Current Accepting new patients
Aurora Medical Group, Inc. Nurse Anesthetist, Certified Registered CurrentSince May 1, 2004 Accepting new patients
Aurora Medical Group, Inc. CurrentSince May 1, 2004 Accepting new patients
Anesthesiology Associates of Sheboygan, LTD. CurrentSince May 1, 2024 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Sep 11, 2019 Accepting new patients

Locations

7395 Solutions Ctr
Chicago, IL 60677

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

13133 N Port Washington Rd
Ste 116
Mequon, WI 53097
Phone (262) 243-3700

13133 N Port Washington Rd
Ste 118
Mequon, WI 53097
Phone (262) 243-7470

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

Bin 88851
Milwaukee, WI 53288

414 Doctors Ct
Oshkosh, WI 54901
Phone (920) 303-5020

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

620 S Wisconsin Dr
Sheboygan, WI 53083
Phone (920) 565-4595

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

3141 Saemann Ave
Sheboygan, WI 53081
Phone (920) 783-1250

3400 Union Ave
Sheboygan, WI 53081
Phone (920) 802-2100

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1780791210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 UNION AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530818426",
            "telephone_number": "920-802-2100",
            "fax_number": "920-802-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOTZBUECHER",
        "first_name": "KARL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "569-033",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "76954-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43298700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kklotzbuecher45012@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2414 Kohler Memorial Dr",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530813129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2414 Kohler Memorial Dr",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530813129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KARL",
            "last_name": "KLOTZBUECHER",
            "middle_name": "JOSEPH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.