Active NPI
Kelly Milberg Novak, CRNA
- Certified Registered Nurse Anesthetist
- Rochester, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2296
- Practice address
- 200 1St St SW
Rochester, MN 55905 - Phone
- (251) 128-4507
- NPI assigned
- Apr 19, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704266242 | MI | |
| Certified Registered Nurse Anesthetist | 367500000X | 4704266242 | MI | |
| Certified Registered Nurse Anesthetist | 367500000X | 2296 | MN | Primary |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905
Mailing address
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Other practice location 1
22101 Moross Rd
Detroit, MI 48236
Phone (734) 474-5019
Other practice location 2
36475 Five Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-2031
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | knovak604452@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, MN
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Michigan State University College of Human Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704266242 | MI | MD | Registered Nurse |
| 2296 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Michigan II PC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| St Mary Mercy Hospital Crna | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Henry Ford Health St. John Hospital | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Henry Ford Health St. John Hospital | Current | Accepting new patients | |
| Mayo Clinic | Current | Accepting new patients | |
| Mayo Clinic | Current | Accepting new patients | |
| Mayo Clinic | Current | Accepting new patients |
Locations
7915 Solutions Ctr Dr
Chicago, IL 60677
350 E Devon Ave
Itasca, IL 60143
22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248
1707 Lake Lansing Rd
Lansing, MI 48912
Phone (517) 267-0033
3400 E Jolly Rd
Lansing, MI 48910
Phone (517) 272-1063
36622 5 Mile Rd
Ste 201
Livonia, MI 48154
Phone (734) 351-5272
36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800
26750 Providence Pkwy
Ste 100
Novi, MI 48374
Phone (248) 662-1500
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
Interoperability endpoints
- knovak604452@ehrdirect.mayoclinicmsg.org
Organizations & group practices 7
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.
-
- Multi-Specialty Clinic/Center
- Rochester, MN
- NPI 1922074434
-
- Certified Registered Nurse Anesthetist
- Detroit, MI
- NPI 1598896995
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Irving, TX
- NPI 1437268026
MI, Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Livonia, MI
- NPI 1063602092
Nurse Anesthetist, Certified Registered
-
- Clinical Medical Laboratory
- Rochester, MN
- NPI 1083249577
-
- Infectious Disease Physician
- Rochester, MN
- NPI 1114343860
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1023088168
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rochester, MN
- NPI 1841266194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1952798845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "55905",
"telephone_number": "251-128-4507"
}
],
"practiceLocations": [
{
"address_1": "22101 Moross Rd",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "48236",
"country_code": "US",
"telephone_number": "734-474-5019",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "36475 Five Mile Rd",
"address_purpose": "LOCATION",
"city": "Livonia",
"state": "MI",
"postal_code": "481541971",
"country_code": "US",
"telephone_number": "734-655-2031",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NOVAK",
"first_name": "KELLY",
"middle_name": "MILBERG",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-19",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704266242",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704266242",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "2296",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "knovak604452@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "200 1st St SW",
"city": "Rochester",
"state": "MN",
"country_code": "US",
"postal_code": "55905",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.