KIMBERLY LODGE (CRNA) – Certified Registered Nurse Anesthetist, NPI 1427026889

KIMBERLY LODGE (CRNA) is a healthcare provider. based in Royal oak, Michigan. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 4704164364 (MI). The NPI Number for KIMBERLY LODGE (CRNA) is 1427026889

Main info

Female
33 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY LODGE (CRNA)
NPI
1427026889
Phone
(248) 423-3144
Address
3601 W 13 MILE RD
Enumeration Date
10 March 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5864167500
Graduation Year
1993 (33 years ago)
PAC ID
8527028901
Group Practice PAC ID
4486790219
Professional Enrollment ID
I20041012000479
Address ID
MI480441156MA17700RDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,692 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MI

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Provider Addresses for KIMBERLY LODGE (CRNA)

  • Beaumont Hospital - Royal Oak, 3601, West 13 Mile Road, Royal Oak, Oakland County, Michigan, 48073, United States

    400 FSC - PCS

    ROYAL OAK, MI 480736769

    Phone: (248) 423-3144

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $36.

Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.

Last reported payment date: 2023-11-21 • Largest payer in this snapshot: IRONWOOD PHARMACEUTICALS, INC ($20).

Total Amount

$36

General + Research + Ownership

Payments

2

Total payment records

General Amount

$36

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-21

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-10-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20041012000479ICertified Registered Nurse Anesthetist (Crna)MITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00811Anesthesia for other procedure on large bowel using an endoscope8180$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope3535$0
00813Anesthesia for procedure on small and large bowel using an endoscope2929$0
00812Anesthesia for exam of colon using an endoscope1818$0
View full utilization report →

Insurance plans in this area (ZIP 48073)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486790219View full group profile
NameSpecialtyState
-MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)IL
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI

Reviews

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Frequently asked questions

What federal number belongs to KIMBERLY LODGE (CRNA)?
The federal identifier for KIMBERLY LODGE (CRNA) is NPI 1427026889.
Is KIMBERLY LODGE (CRNA) active in the national directory?
KIMBERLY LODGE (CRNA)'s public NPI profile is in an active state.
What kind of provider is KIMBERLY LODGE (CRNA)?
The page reflects Certified Registered Nurse Anesthetist for KIMBERLY LODGE (CRNA). Clinical services aligned with this taxonomy classification.
Where does public data place KIMBERLY LODGE (CRNA)?
The snapshot lists Royal Oak, Michigan for KIMBERLY LODGE (CRNA); download NPPES for the complete set.
Is KIMBERLY LODGE (CRNA) a real provider?
This page reflects official NPPES data for NPI 1427026889. Always confirm identity and privileges with the practice and licensing boards.

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