Michele L Mack, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704172231 Issued in MI

Practice address

18100 Oakwood Blvd
Suite 100
Dearborn, MI 48124-4085

Phone

(313) 253-2000

NPI assigned

Jul 10, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northstar Anesthesia of Michigan PLLCGroup PAC ID 9638481591, 192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harper University Hospital Hospital, Detroit, MI, CCN 230104
• Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations (25 of 26)

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northstar Anesthesia of Michigan PLLC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1871986372

  MI, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Ambulatory Anesthesia Associates, PC

  • Anesthesiology Physician
  • Monroe, MI
  • NPI 1952350555

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Conquest Pain Management, LLC

  • Certified Registered Nurse Anesthetist
  • Wyandotte, MI
  • NPI 1164871216

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Henry Ford Health Rochester Hospital

  • Certified Registered Nurse Anesthetist
  • Rochester, MI
  • NPI 1235252321

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Macomb Endoscopy Center PLC

  • Ambulatory Surgical Clinic/Center
  • Macomb, MI
  • NPI 1780923128
  Medicare reassignment NPD
• Motor City Anesthesia Services PLLC

  • Anesthesiology Physician
  • Dearborn, MI
  • NPI 1457058125
  Medicare reassignment NPD
• Southfield Rehabilitation Company

  dba Surgeons Choice Medical Center

  • General Acute Care Hospital
  • Southfield, MI
  • NPI 1790785095

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Superior Anesthetists Associates, Inc.

  • Specialist
  • Troy, MI
  • NPI 1831144518
  Medicare reassignment NPD
• Surgical Centers of Michigan, LLC.

  • Ambulatory Surgical Clinic/Center
  • Troy, MI
  • NPI 1962463133
  Medicare reassignment NPD
• Northstar Anesthesia of Michigan II PC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1437268026

  MI, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Henry Ford Health Rochester Hospital

  • Family Medicine Physician
  • Rochester, MI
  • NPI 1184747263
  NPD
• Macomb Endoscopy Center, PLC

  dba Anesthesia MEC

  • Anesthesiology Physician
  • Macomb, MI
  • NPI 1821498536
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barbara Ann Karmanos Cancer Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1316900277
  Care Compare affiliation
• VHS Harper-Hutzel Hospital Inc

  dba Harper University Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1427360700
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013941921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18100 OAKWOOD BLVD",
            "address_2": "SUITE 100",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244085",
            "telephone_number": "313-253-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18100 OAKWOOD BLVD",
            "address_2": "SUITE 100",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244085",
            "telephone_number": "313-253-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "MICHELE",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704172231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4852368",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4793024",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirin Maalhagh Fard
• Bassam M Maaz, MD
• Alan Macdonald, CCC-SLP
• Mark Steven Macdonald, D.D.S.
• Rima Machhour
• Fatmeh Mackie
• Tamara Mackie, DDS
• Miranda M Macko, AGNP-C
• Macomb Physical Therapy & Rehab LLC
• Haris C. Macris, M.D.

• Certified Registered Nurse Anesthetist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.