Kristopher Matelic, CRNA
Kristopher Matelic, CRNA is a Certified Registered Nurse Anesthetist in Detroit, MI, registered under NPI 1407243835. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 3990 JOHN R ST, Detroit, MI 48201. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 4704270927 | MI | Certified Registered Nurse Anesthetist primary |
| 4704270927 | MI | Registered Nurse |
| 240691 | AK | Certified Registered Nurse Anesthetist |
Licences are recorded in 2 states: MI, AK. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Certified Registered Nurse Anesthetist (crna)
- PAC ID
- 2163735788
Enrolled in Medicare 3 times, across 3 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Michigan | I20150724011100 | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Washington | I20230118001068 | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Alaska | I20250807002088 | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Medicare enrolment is recorded as approved under the provider type Practitioner - Certified Registered Nurse Anesthetist (crna). There are 3 separate enrolment records across 3 states (MI, WA, AK). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 2 states
This provider holds licences in 2 states: Alaska and Michigan. The practice address on file is in Detroit, MI, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- 4704270927
- Specialty
- Certified Registered Nurse Anesthetist
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Nurse Anesthetist, Certified Registered covers
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. NUCC Health Care Provider Taxonomy, code 367500000X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 367500000X | Certified Registered Nurse Anesthetist | 4704270927 | MI | primary |
| 163W00000X | Registered Nurse | 4704270927 | MI | |
| 367500000X | Certified Registered Nurse Anesthetist | 240691 | AK |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1407243835 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Apr 23, 2015 |
| Last updated | Jul 29, 2025 |
| Status | Active |
| Sole proprietor | No |
| Credential | CRNA |
| Practice address |
3990 JOHN R ST Detroit, MI 48201 (313) 745-2000 |
| Mailing address |
4106 MERRICK ST Dearborn Heights, MI 48125 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 4 | 0 | 7 | 2 | 4 | 3 | 8 | 3 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 4 | 0 | 7 | 4 | 4 | 6 | 8 | 6 |
Sum = 65 · next multiple of 10 = 70 · check digit = 5 · actual last digit = 5
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.