Michael Dale Lance II, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Louisville, KY
NPI 1063032001 · NPPES record last updated Aug 5, 2020
Key facts
- NPI
- 1063032001
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 3014694 (KY)
- Practice address
- 530 S Jackson St
Louisville, KY 40202-1675 - Phone
- (502) 852-1735
- Fax
- (502) 852-6056
- NPI assigned
- Apr 20, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Apollo Medical Group of Jeffersonville LLC
Practice addresses (Care Compare)
400 Corporate Dr
Suite 100
Jeffersonville, IN 47130-1502
Phone (812) 925-1051
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.96 of 100
- Quality
- 56.12
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.73
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY, IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200729002255 | KY | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 1052736733 | Reassigns benefits to 2 organizations |
| I20240405001312 | IN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 1052736733 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3014694 | KY | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Louisivlle Physicians | Current |
Accepting new patients | |
| Ema Anesthesia, PSC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| University of Louisville Physicians, Inc. | Current |
Accepting new patients | |
| University of Louisville Physicians, Inc. | Current | Accepting new patients |
Locations
7752 Solution Ctr
Chicago, IL 60677
360 Missouri Ave
Ste 102
Jeffersonvlle, IN 47130
Phone (502) 364-0902
101 Financial Pl
Ste B103
Elizabethtown, KY 42701
Phone (270) 307-8177
571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700
200 Abraham Flexner Way
Louisville, KY 40202
Phone (502) 569-7983
1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767
1169 Eastern Pkwy
Ste 400
Louisville, KY 40217
Phone (502) 276-5554
530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 3014694 | KY | Yes |
Addresses
Primary practice location
530 S Jackson St
Louisville, KY 40202-1675
Mailing address
PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0328
Other practice location 1
200 Abraham Flexner Way
Louisville, KY 40202-2877
Phone (502) 587-4044
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100679990 | Medicaid | KY | |
| 300040935 | Medicaid | IN |
Other providers in Louisville, KY
- Marian Lancaster
- Suzanne Lancaster
- Lance S Ferguson MD PSC
- Daniel Roy Lance
- Margaret Glaser Lance
- Neritta C Lanceta
- Catherine Celeste Land
- Jane Curtis Land
- Landau Radiology Ky PLLC
- Greta Jean Landenwich
All providers in Louisville, KY · Certified Registered Nurse Anesthetist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.