NPIMap

Individual provider Active NPI

Kemo Marong, CRNA

  • Certified Registered Nurse Anesthetist
  • Brooklyn Park, MN
National Provider Identifier
1992174940
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA 1801 Issued in MN
Practice address
9618 Scott LN N
Brooklyn Park, MN 55443-5101
Phone
(320) 291-8635
NPI assigned
Sep 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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 CRNA 1801 MN Primary

Addresses

Primary practice location

9618 Scott LN N
Brooklyn Park, MN 55443-5101

Mailing address

9618 Scott LN N
Brooklyn Park, MN 55443-5101
Phone (320) 291-8635

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151006000018 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618285032 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (651) 262-7633

Hospital & facility affiliations

  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CRNA 1801MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jan 27, 2025 Accepting new patients
Mngi Digestive Health, P.a. CurrentSince Oct 4, 2021 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2016 Accepting new patients
Allina Health System Nurse Anesthetist, Certified Registered CurrentSince Jan 27, 2025 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients

Locations

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

3001 Broadway St NE
Ste 500
Minneapolis, MN 55413
Phone (612) 870-5557

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

8100 W 78th St
Ste 220
Minneapolis, MN 55439
Phone (952) 914-8400

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1992174940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9618 SCOTT LN N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554435101",
            "telephone_number": "320-291-8635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9618 SCOTT LN N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554435101",
            "telephone_number": "320-291-8635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARONG",
        "first_name": "KEMO",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "CRNA 1801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.