MR. KEVIN SISTANI (NPI# 1659834562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659834562 |
| Entity Type | Individual |
| Full Name | MR. KEVIN SISTANI |
| Credential | A.A. |
| Practice Address |
100 Michigan St Ne Grand Rapids MI 49503 |
| Mailing Address |
3333 Evergreen Dr Ne Grand Rapids MI 49525-9493 |
| Practice Telephone | 6163644200 |
| Practice Fax Number | 6163647347 |
| Mailing Telephone | 6163644200 |
| Mailing Fax Number | 6163647347 |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2019-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | 28513167 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367H00000X | Anesthesiologist Assistant | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 615 S New Ballas Rd Dept Of, Saint Louis, MO 631418221 | 3142516000 |
| Street Address |
100 MICHIGAN ST NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922001668 | Surender Rajasekaran | Anesthesiology | 100 Michigan St Ne, Mc 117, Grand Rapids, MI 49503-2560 | 2005-05-26 |
| 1710587415 | Mara S Brown | Registered Nurse | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2020-10-30 |
| 1033718044 | Anh Thi Mai Huynh | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2020-10-21 |
| 1427687201 | Kayla Renee Smith | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2020-04-03 |
| 1407487424 | Jessica B Doorn | Dietitian, Registered | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2020-01-29 |
| 1649810391 | Olivia Lauren Presnell | Physician Assistant | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2020-01-10 |
| 1316586381 | Keith Minbiole | Anesthesiologist Assistant | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-12-23 |
| 1427697499 | Alexander Linkner | Anesthesiologist Assistant | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-12-23 |
| 1619514593 | Louise Mcwhirter | Anesthesiology | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-12-10 |
| 1316584915 | Professional Treatment Solutions PC | Anesthesiology | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205454998 | Andrea Mantel | Anesthesiologist Assistant | 3333 Evergreen Dr Ne, Grand Rapids, MI 49525-9493 | 2020-07-08 |
| 1316586381 | Keith Minbiole | Anesthesiologist Assistant | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-12-23 |
| 1427697499 | Alexander Linkner | Anesthesiologist Assistant | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-12-23 |
| 1811541774 | Skylar Bayer | Anesthesiologist Assistant | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-07-30 |
| 1497217335 | Nicholas Simpson | Anesthesiologist Assistant | 3333 Evergreen Dr Ne, Grand Rapids, MI 49525-9493 | 2019-04-01 |
| 1841796752 | Mason Fisher | Anesthesiologist Assistant | 3333 Evergreen Dr Ne, Grand Rapids, MI 49525-9493 | 2018-04-02 |
| 1134645963 | Meghan Fowler | Anesthesiologist Assistant | 3333 Evergreen Dr Ne, Grand Rapids, MI 49525-9493 | 2017-08-14 |
| 1396150066 | Ina Stashonsky | Anesthesiologist Assistant | 3333 Evergreen Dr Ne, Grand Rapids, MI 49525-9493 | 2014-06-21 |
| 1336403823 | Mark Allen Hoogerhyde | Anesthesiologist Assistant | 3333 Evergreen Dr Ne, Grand Rapids, MI 49525-9493 | 2012-06-28 |
| 1851679807 | Landon L Lapham | Anesthesiologist Assistant | 3333 Evergreen Dr Ne, Grand Rapids, MI 49525-9493 | 2011-07-25 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.