Individual provider Active NPI

Kimberly J Jasinski, CRNA

  • Certified Registered Nurse Anesthetist
  • Dearborn, MI
National Provider Identifier
1881790145
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704214433 Issued in MI
Practice address
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone
(313) 593-7820
Fax
(313) 593-8894
NPI assigned
Sep 15, 2006
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 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 APRN.CRNA.019901 OH
Certified Registered Nurse Anesthetist 367500000X 4704214433 MI Primary

Addresses

Primary practice location

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Mailing address

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 593-7820

Other practice location 1

5700 Monroe St Unit 102
Sylvania, OH 43560-2779
Phone (419) 893-7996

Other practice location 2

500 Osborn Blvd
Sault Sainte Marie, MI 49783-1822
Phone (190) 625-3102

Other identifiers 2

IdentifierTypeStateIssuer
4835680MedicaidMI
4486604MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kjasinski92388@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040319000820 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527958628 Reassigns benefits to 3 organizations
I20190913000789 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527958628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Wayne State University School of Medicine, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians
Jebs Anesthesia Consultants, LLCGroup PAC ID 4486046646, 37 clinicians
Mymichigan Medical Center SaultGroup PAC ID 7315936481, 101 clinicians

Practice addresses (Care Compare)

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (214) 687-0001

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

3509 Briarfield Blvd
Maumee, OH 43537-9383
Phone (419) 865-3866

500 Osborn Blvd
Sault S Marie, MI 49783-1822
Phone (906) 635-4460

5640 N Adrian Hwy
Adrian, MI 49221-8318
Phone (419) 291-4491

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704214433MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Sep 1, 2020 Accepting new patients
Mercy Memorial Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Jan 13, 2009 Accepting new patients
Mercy Memorial Hospital Corporation CurrentSince Jan 13, 2009 Accepting new patients
Mymichigan Medical Center Sault CurrentSince Nov 7, 2022 Accepting new patients
Mymichigan Medical Center Sault CurrentSince Nov 7, 2022 Accepting new patients
Promedica Central Corporation of Michigan CurrentSince Nov 2, 2022 Accepting new patients
Promedica Central Physicians CurrentSince Sep 1, 2020 Accepting new patients
Jebs Anesthesia Consultants, LLC CurrentSince Dec 1, 2022 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2020 Accepting new patients
Anesthesia Office Consultants, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Ambulatory Anesthesia Associates, PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

5640 N Adrian Hwy
Adrian, MI 49221
Phone (419) 291-3000

818 Riverside Ave
Adrian, MI 49221
Phone (517) 263-0711

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

3175 Smith Rd
Lambertville, MI 48144
Phone (734) 856-5494

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350

200 E Russell Rd
Unit C
Tecumseh, MI 49286
Phone (517) 424-3883

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

3509 Briarfield Blvd
Maumee, OH 43537
Phone (419) 865-3566

5700 Monroe St
Unit 102
Sylvania, OH 43560
Phone (419) 843-7996

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 4

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1881790145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7820",
            "fax_number": "313-593-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7820",
            "fax_number": "313-593-8894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 Monroe St Unit 102",
            "address_purpose": "LOCATION",
            "city": "Sylvania",
            "state": "OH",
            "postal_code": "435602779",
            "country_code": "US",
            "telephone_number": "419-893-7996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Osborn Blvd",
            "address_purpose": "LOCATION",
            "city": "Sault Sainte Marie",
            "state": "MI",
            "postal_code": "497831822",
            "country_code": "US",
            "telephone_number": "190-625-3102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JASINSKI",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2023-11-03",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.019901",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704214433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4835680",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4486604",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjasinski92388@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.