MRS. ELIZABETH CLEARY KINGSTEDT (CRNA) – Certified Registered Nurse Anesthetist, NPI 1356744882

MRS. ELIZABETH CLEARY KINGSTEDT (CRNA) is a healthcare provider. based in Champlin, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. R 206981-6 (MN). The NPI Number for MRS. ELIZABETH CLEARY KINGSTEDT (CRNA) is 1356744882

Main info

Female
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
MRS. ELIZABETH CLEARY KINGSTEDT (CRNA)
NPI
1356744882
Phone
(612) 360-9484
Address
11416 YATES AVE N
Enumeration Date
29 September 2014
Last Update Date
12 December 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9523683800
Graduation Year
2014 (12 years ago)
PAC ID
9335563071
Group Practice PAC ID
8426423039
Professional Enrollment ID
I20200728001156
Address ID
MN553182525CH1447XDRXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

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

Provider Addresses for MRS. ELIZABETH CLEARY KINGSTEDT (CRNA)

  • 11416 YATES AVE N

    CHAMPLIN, MN 553162908

    Phone: (612) 360-9484

    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)

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: 2020-07-28

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
I20200728001156ICertified 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55316)

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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: 8426423039View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YMN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN

Reviews

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Frequently asked questions

What federal number belongs to MRS. ELIZABETH CLEARY KINGSTEDT (CRNA)?
The federal identifier for MRS. ELIZABETH CLEARY KINGSTEDT (CRNA) is NPI 1356744882.
Is MRS. ELIZABETH CLEARY KINGSTEDT (CRNA) active in the national directory?
MRS. ELIZABETH CLEARY KINGSTEDT (CRNA)'s public NPI profile is in an active state.
Can you summarize MRS. ELIZABETH CLEARY KINGSTEDT (CRNA)'s specialty in plain language?
Clinically, the directory lists MRS. ELIZABETH CLEARY KINGSTEDT (CRNA) with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What location metadata exists for MRS. ELIZABETH CLEARY KINGSTEDT (CRNA)?
The page summarizes Champlin, Minnesota for MRS. ELIZABETH CLEARY KINGSTEDT (CRNA); expand the address list for detail.
Is MRS. ELIZABETH CLEARY KINGSTEDT (CRNA) a real provider?
This page reflects official NPPES data for NPI 1356744882. Always confirm identity and privileges with the practice and licensing boards.

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