NPIMap

Organization Active NPI

Alliance Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Flint, MI
National Provider Identifier
1063880052
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704215191 Issued in MI
Legal business name
ALLIANCE ANESTHESIA PLLC
Practice address
4800 S Saginaw St
Flint, MI 48507-2677
Phone
(810) 732-8336
Fax
(810) 239-4346
NPI assigned
Sep 8, 2015
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Atif Bawahab
Title
Admin
Phone
(979) 574-7109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704215191 MI Primary

Addresses

Primary practice location

4800 S Saginaw St
Flint, MI 48507-2677

Mailing address

4800 S Saginaw St
Ste 1845
Flint, MI 48507-2677
Phone (810) 732-8336

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151001001050 MI Part B Supplier - Clinic/Group Practice 0143538769 Receives reassigned benefits from 75 practitioners
Practice locations: Flint, MI

National Provider Directory

National Provider Directory

Locations

4800 S Saginaw St
Ste 1845
Flint, MI 48507
Phone (810) 275-9152

Practitioners & affiliated clinicians

Practitioners 76

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 76

NPI Registry JSON

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1063880052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 S SAGINAW ST",
            "address_2": "STE 1845",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072677",
            "telephone_number": "810-732-8336",
            "fax_number": "810-239-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 S SAGINAW ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072677",
            "telephone_number": "810-732-8336",
            "fax_number": "810-239-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-08",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "BAWAHAB",
        "authorized_official_first_name": "ATIF",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "979-574-7109"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704215191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.