Individual provider Active NPI

Kevin Steven Senko, CRNA

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1881924603
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704245992 Issued in MI
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 745-7600
NPI assigned
Dec 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704245992 MI Primary

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

PO Box 67000
Dept 203401
Detroit, MI 48267-2034
Phone (888) 278-4124

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000046 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193856664 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians
Northstar Anesthesia of Michigan PLLCGroup PAC ID 9638481591, 192 clinicians

Practice addresses (Care Compare)

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

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3615

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704245992MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2015 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Conquest Pain Management, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2020 Accepting new patients

Locations

4 Columbus Ave
Ste 260
Bay City, MI 48708
Phone (989) 308-1840

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

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

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

31995 Northwestern Hwy
Farmington Hills, MI 48334
Phone (248) 538-4701

375 Barclay Cir
Rochester Hills, MI 48307
Phone (248) 491-8894

29877 Telegraph Rd
Southfield, MI 48034
Phone (248) 352-1890

15750 Northline Rd
Southgate, MI 48195
Phone (248) 798-3130

43145 Schoenherr Rd
Unit 13
Sterling Heights, MI 48313
Phone (586) 997-5048

3290 W Big Beaver Rd
Ste 150
Troy, MI 48084
Phone (248) 792-6527

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

2333 Progress St
West Branch, MI 48661
Phone (989) 343-3178

400 10th St E
Waconia, MN 55387

Organizations & group practices 3

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 3

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": "1262044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1881924603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000",
            "address_2": "DEPT 203401",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672034",
            "telephone_number": "888-278-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENKO",
        "first_name": "KEVIN",
        "middle_name": "STEVEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704245992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.