Individual provider Active NPI

Philip Ross Lepine, CRNA

  • Certified Registered Nurse Anesthetist
  • Port Huron, MI
National Provider Identifier
1023536190
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704270813 Issued in MI
Practice address
1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone
(810) 987-5000
NPI assigned
Sep 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704270813 MI Primary

Addresses

Primary practice location

1221 Pine Grove Ave
Port Huron, MI 48060-3511

Mailing address

911 Georgia Ave
Marysville, MI 48040-1277

Other practice location 1

911 Georgia Ave
Marysville, MI 48040-1277
Phone (810) 531-4964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171006000531 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082989728 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Michigan Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asa Staffing IncGroup PAC ID 3971898644, 146 clinicians
Lakeshore Surgery Anesthesia BillingGroup PAC ID 6709321268, 8 clinicians

Practice addresses (Care Compare)

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

4190 24TH Ave
Fort Gratiot, MI 48059-3882
Phone (810) 216-4300

Hospital & facility affiliations

  • McLaren Port Huron Hospital, Port Huron, MI, CCN 230216
  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Services-Port Huron LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2023 Accepting new patients
Lakeshore Surgery Anesthesia Billing Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2024 Accepting new patients
Prime Healthcare Services-Port Huron LLC CurrentSince May 1, 2023 Accepting new patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2017 Accepting new patients
Prime Healthcare Services-Port Huron LLC Past Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

4190 24th Ave
Fort Gratiot, MI 48059
Phone (810) 216-4300

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

2601 Electric Ave
#C
Port Huron, MI 48060
Phone (810) 216-1500

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023536190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 GEORGIA AVE",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480401277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-987-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 Georgia Ave",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "MI",
            "postal_code": "480401277",
            "country_code": "US",
            "telephone_number": "810-531-4964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEPINE",
        "first_name": "PHILIP",
        "middle_name": "ROSS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704270813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.