KELLIE MARTIN (CRNA) – Certified Registered Nurse Anesthetist, NPI 1629032636
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,692 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MI
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Provider Addresses for KELLIE MARTIN (CRNA)
39086, Vassar Avenue, Sterling Heights, Macomb County, Michigan, 48313, United States
STERLING HEIGHTS, MI 48313
Phone: (586) 532-7074
Type: Mailing
St. John Hospital and Medical Center, 22101, Moross Road, Detroit, Wayne County, Michigan, 48236, United States
DETROIT, MI 48226
Phone: (313) 343-4766
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $122.
Total Amount is formed as General ($122) + Research ($0) + Ownership ($0) = $122.
Last reported payment date: 2023-05-16 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($122).
Total Amount
$122
General + Research + Ownership
Payments
1
Total payment records
General Amount
$122
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| W. L. Gore & Associates, Inc. | $122 |
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: 2004-12-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041203000569 | I | Certified Registered Nurse Anesthetist (Crna) | MI | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 20 | 20 | $0 |
Insurance plans in this area (ZIP 48313)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| - | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Orthopedic Surgery | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| - | MI | |
| Cardiovascular Disease (Cardiology) | NC | |
| Cardiovascular Disease (Cardiology), Internal Medicine | IN |
Reviews
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