KELLIE MARTIN CRNA
NPI 1629032636
Nurse Anesthetist, Certified Registered in Detroit, MI
About Kellie Martin Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLIE MARTIN CRNA (NPI 1629032636) is an individual nurse anesthetist, certified registered in Detroit, Michigan, licensed in Michigan (4704173942) and active in the NPI registry since April 2006. She is affiliated with Ascension Macomb Oakland Hosp-warren Campus and is a graduate of Other (1996).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kellie Martin Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Kellie Martin reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Saint Clair Shores, MI 48081
- Reassigned Medicare billing, Michigan enrollment
- 99 clinicians in this Medicare group
Warren, MI 48093
- Reassigned Medicare billing, Michigan enrollment
- Also billed through NPI 1871793505 (Michigan)
- 78 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ascension Macomb Oakland Hosp-Warren Campus
Acute Care Hospitals · Warren, MIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48226 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kellie Martin's NPI number?
The NPI number for Kellie Martin is 1629032636. It was assigned to this individual provider in the NPPES registry on April 14, 2006.
Where is Kellie Martin located?
Kellie Martin practices at 22101 Moross, Detroit, MI 48226. The listed phone number is (313) 343-4766.
What is Kellie Martin's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Kellie Martin enrolled in Medicare?
Yes. Kellie Martin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kellie Martin's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kellie Martin reassigns Medicare benefits to 2 organizations: Eastside Group LLC (Saint Clair Shores, MI) and Henry Ford Health Macomb Oakland Hospital (Warren, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kellie Martin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Kellie Martin affiliated with any hospitals?
According to CMS data, Kellie Martin is affiliated with Ascension Macomb Oakland Hosp-Warren Campus.
When was this NPI record last updated?
The NPPES record for Kellie Martin was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kellie Martin, CRNA · NPI 1629032636
Nurse Anesthetist, Certified Registered physician in Detroit, Michigan. Individual provider, active in the CMS NPPES registry since April 14, 2006.
## Identity
- **NPI:** 1629032636 (Entity type: Individual)
- **Enumerated:** April 14, 2006
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 4704173942 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 22101 MOROSS, Detroit, MI 48226
- **Phone:** (313) 343-4766
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Eastside Group LLC (NPI 1235365289, Saint Clair Shores, MI); Henry Ford Health Macomb Oakland Hospital (NPI 1396789434, Warren, MI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1996
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Other KM173942 (MI); Medicare ID-Type Unspecified N24360270 (MI)
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Source: [NPI Profile](https://npiprofile.com/npi/1629032636) · Data from the CMS NPPES public registry.