Karl Kettelhut, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209022754 Issued in IL

Practice address

701 W North Ave
Melrose Park, IL 60160-1612

Phone

(708) 681-3200

NPI assigned

Feb 9, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, MI2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Muskegon Surgical Associates PCGroup PAC ID 0941262877, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Muskegon Surgical Associates PC

  • Surgery Physician
  • Muskegon, MI
  • NPI 1225101660

  MI

  Medicare reassignment Care Compare group NPD
• Gottlieb Midwest Anesthesiologists, LLC

  • Anesthesiology Physician
  • Melrose Park, IL
  • NPI 1003832767

  IL

  Medicare reassignment NPD
• Midwest Anesthesia Partners, LLC

  • Anesthesiology Physician
  • Chicago, IL
  • NPI 1255380184

  IL

  Medicare reassignment NPD
• Muskegon Surgical Associates Surgicenter, PLC

  • Ambulatory Surgical Clinic/Center
  • Muskegon, MI
  • NPI 1184485146
  NPD (past)

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1861084014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3613",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601323613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601612",
            "telephone_number": "708-681-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTELHUT",
        "first_name": "KARL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209022754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaya Kasturi, M.D.
• Kasturi, P.C.
• Anastasia Katopodis, CNM
• Tamayo Kawai, M.D.
• Jacara Kelley-Muhammad, M.D.
• Khalil Y Karim, MD, SC
• Asmat Khan, MAFP
• Khurana Family Eyecare, PLLC
• Jacqueline Kibir-Evans
• Kyung Mo Kim, RPH

• All providers in Melrose Park, IL
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.