MICHAEL S KENNEDY (CRNA) – Certified Registered Nurse Anesthetist, NPI 1063414738

MICHAEL S KENNEDY (CRNA) is a healthcare provider. based in Coon rapids, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. R 093139-9 (MN). The NPI Number for MICHAEL S KENNEDY (CRNA) is 1063414738

Main info

Male
41 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL S KENNEDY (CRNA)
NPI
1063414738
Phone
Not provided
Address
11490 SILVEROD ST NW
Enumeration Date
12 August 2005
Last Update Date
15 May 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512543456
Graduation Year
1985 (41 years ago)
PAC ID
9830378488
Group Practice PAC ID
9133491194
Professional Enrollment ID
I20110127000950
Address ID
MN551012502SA640XXSTXX300
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

2,131 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MN

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Provider Addresses for MICHAEL S KENNEDY (CRNA)

  • 11490, Silverod Street Northwest, Pheasant Ridge, Coon Rapids, Anoka County, Minnesota, 55433, United States

    COON RAPIDS, MN 554332640

    Phone:

    Type: Mailing

  • 8990, Springbrook Drive Northwest, Parkside, Coon Rapids, Anoka County, Minnesota, 55433, United States

    COON RAPIDS, MN 554335884

    Phone: (763) 398-0099

    Fax: (763) 398-0124

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2011-01-27

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
I20110127000950ICertified Registered Nurse Anesthetist (Crna)MNTBD

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
01402Anesthesia for procedure for total knee joint replacement1111$0
View full utilization report →

Insurance plans in this area (ZIP 55433)

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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: 9133491194View full group profile
NameSpecialtyState
-MN
Certified Registered Nurse Anesthetist (Crna)MN
-PA
Certified Registered Nurse Anesthetist (Crna)MN
A N E S T H E S I O L O G YMN
-MN
A N E S T H E S I O L O G YPA
A N E S T H E S I O L O G YMN
-MN
Certified Registered Nurse Anesthetist (Crna)WI

Reviews

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Frequently asked questions

What is the 10-digit NPI for MICHAEL S KENNEDY (CRNA)?
MICHAEL S KENNEDY (CRNA) — NPI 1063414738 — is the standard way to identify this listing.
Can I rely on MICHAEL S KENNEDY (CRNA) being an active provider?
As of the registry snapshot, MICHAEL S KENNEDY (CRNA) is marked active.
What is MICHAEL S KENNEDY (CRNA)'s specialty?
The listing groups MICHAEL S KENNEDY (CRNA) with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where is MICHAEL S KENNEDY (CRNA) based?
MICHAEL S KENNEDY (CRNA) is tied to Coon Rapids, Minnesota in the data we show; additional addresses may exist on the full record.
Is the information about MICHAEL S KENNEDY (CRNA) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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