NPIMap

Organization Active NPI

Nurse Anesthesia Professional Services LLC

  • Certified Registered Nurse Anesthetist
  • Green Bay, WI
National Provider Identifier
1992066518
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
NURSE ANESTHESIA PROFESSIONAL SERVICES LLC
Practice address
1077 W Mason St
Green Bay, WI 54303-1858
Phone
(920) 497-1810
Fax
(920) 497-1830
NPI assigned
May 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Authorized official

Name
Kristi R Sarosiek, CRNANPI 1144232836
Title
President
Phone
(920) 469-1474

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1077 W Mason St
Green Bay, WI 54303-1858

Mailing address

PO Box 37
Kimberly, WI 54136-0037
Phone (920) 815-3500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120803000210 WI Part B Supplier - Clinic/Group Practice 6507012713 Receives reassigned benefits from 17 practitioners
Practice locations: Appleton, WI; Green Bay, WI; Neenah, WI

National Provider Directory

National Provider Directory

Locations

1077 W Mason St
Green Bay, WI 54303
Phone (920) 497-1810

736 Ford St
Kimberly, WI 54136

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1992066518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "KIMBERLY",
            "state": "WI",
            "postal_code": "541360037",
            "telephone_number": "920-815-3500",
            "fax_number": "920-939-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1077 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031858",
            "telephone_number": "920-497-1810",
            "fax_number": "920-497-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSE ANESTHESIA PROFESSIONAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-30",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "SAROSIEK",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-469-1474",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.