Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kristopher Michael Matelic, CRNA

Individual provider Registered Nurse · NPI 1407243835

Kristopher Michael Matelic, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Detroit, Michigan. Qualified in 2015, 11 years ago. Practices with Providence Health and Service- Washington, a 172-clinician group and accepts Medicare assignment. Licensed in Alaska and Michigan.

Years since qualifying
11
Licensed in
AK, MI
In the registry since
2015
Specialties on file
3
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

3990 John R St
Detroit, MI 48201-2018
Phone: (313) 745-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 4704270927 (MI)
Registered Nurse Taxonomy 163W00000X · Licence 4704270927 (MI)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 240691 (AK)

Record details

NPI number1407243835
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedApril 23, 2015
Last updated in NPPESJuly 29, 2025
Certification dateJuly 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Providence Health And Service- Washington — 172 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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