Individual provider Active NPI

Michael James Petsch, CRNA

  • Certified Registered Nurse Anesthetist
  • Niagara Falls, NY
National Provider Identifier
1033165626
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP116620 Issued in TX
Practice address
621 10TH St
Niagara Falls, NY 14301-1813
Phone
(716) 278-4000
NPI assigned
May 25, 2006
Last updated
May 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 498634 NY
Certified Registered Nurse Anesthetist 367500000X AP116620 TX Primary

Addresses

Primary practice location

621 10TH St
Niagara Falls, NY 14301-1813

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 648-7833

Other practice location 1

5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone (214) 648-7833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051101000072 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183657976 Reassigns benefits to 5 organizations
I20081223000048 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183657976 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grasshopper Anesthesia Services PLLCGroup PAC ID 3072882315, 70 clinicians
Premier Anesthesia of New York, P.C.Group PAC ID 7719041102, 50 clinicians

Practice addresses (Care Compare)

110 Shult Dr
Columbus, TX 78934-3016
Phone (979) 732-2371

207 Foote Ave
Jamestown, NY 14701-7077
Phone (716) 487-0141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.09 of 100Reported as group
Quality
97.07
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of New York, P.C. Nurse Anesthetist, Certified Registered CurrentSince Aug 2, 2017 Accepting new patients
Quality Medical Management Corp Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients
Allen Anesthesia Associates CurrentSince Sep 1, 2025 Accepting new patients
Great Lakes Anesthesiology, PC CurrentSince Sep 15, 2022 Accepting new patients
Syracuse Gastroenterological Associates PC CurrentSince May 8, 2024 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Syracuse Gastroenterological Associates.PC Current Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Sep 5, 2023 Accepting new patients
Upstate New York Medical Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Jan 28, 2022 Accepting new patients
NTX Anesthesiology Consultants PLLC CurrentSince Feb 1, 2024 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 15, 2020 Accepting new patients
American Anesthesiology of Syracuse, PC Past Accepting new patients
Westfield Memorial Hospital, Inc. Past Accepting new patients

Locations (25 of 28)

7 Southwoods Blvd
Ste 4
Albany, NY 12211

11 E Fordham Rd
Ste A
Bronx, NY 10468
Phone (631) 446-1190

3095 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 896-2245

529 Central Ave
Dunkirk, NY 14048
Phone (716) 338-9797

5000 Campuswood Dr
Ste 100
East Syracuse, NY 13057
Phone (315) 234-6687

5000 Campuswood Dr
Ste 200
East Syracuse, NY 13057

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

1324 Motor Pkwy
Ste 101
Islandia, NY 11749
Phone (516) 850-8143

16203 Jamaica Ave
Ste 200
Jamaica, NY 11432
Phone (347) 429-7699

207 Foote Ave
Jamestown, NY 14701
Phone (716) 487-0141

7209 Buckley Rd
Liverpool, NY 13088
Phone (315) 299-5451

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

515 Main St
Olean, NY 14760
Phone (716) 373-2600

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

400 N Main St
Warsaw, NY 14569
Phone (585) 786-1555

1105 Central Expy N
Ste 210
Allen, TX 75013
Phone (972) 747-4646

906 W McDermott Dr
Allen, TX 75013
Phone (918) 812-4755

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

4401 Coit Rd
Ste 100
Frisco, TX 75035
Phone (214) 619-0120

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

4510 Medical Center Dr
Ste 211
McKinney, TX 75069
Phone (469) 541-1600

2704 N Galloway Ave
Ste 102
Mesquite, TX 75150
Phone (972) 961-7171

Organizations & group practices 16

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

View all 16

Hospital & facility affiliations 1

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1033165626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-648-7833",
            "fax_number": "214-648-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 10TH ST",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143011813",
            "telephone_number": "716-278-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753907201",
            "country_code": "US",
            "telephone_number": "214-648-7833",
            "fax_number": "214-648-6799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETSCH",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "498634",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP116620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.