Shannon Boldenow
NPI 1720628357ActiveIndividual· Nurse Anesthetist, Certified Registered· Pontiac, MI
Nurse Anesthetist, Certified Registered with Northstar Anesthesia of Michigan III PLLC, practicing in Pontiac, Michigan. Medicare paid $8,858 for services to 93 patients in 2024. Lists Beaumont Hospital, Troy as a hospital affiliation.
Overview
| NPI | 1720628357 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jan 12, 2020 |
| Last updated in NPPES | Jan 12, 2020 |
| Certified by provider | Jan 12, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | 4704283091 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (MI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 93 |
|---|---|
| Services billed | 94 across 32 procedure codes |
| Paid by Medicare | $8,858 |
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Certified Registered Nurse Anesthetist (Crna) |
Medical group
- Northstar Anesthesia of Michigan III PLLCDearborn, MI · 561 clinicians
Hospital affiliation
- Beaumont Hospital, TroyTroy, MI
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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