Individual provider Active NPI

Michelle Bainbridge, CRNA

  • Certified Registered Nurse Anesthetist
  • Lancaster, WI
National Provider Identifier
1073518601
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
110438-030 Issued in WI
Practice address
507 S Monroe St
Lancaster, WI 53813-2054
Phone
(608) 723-2143
NPI assigned
Jun 20, 2005
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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 110438-030 WI Primary

Addresses

Primary practice location

507 S Monroe St
Lancaster, WI 53813-2054

Mailing address

507 S Monroe St
Lancaster, WI 53813-2054
Phone (608) 723-2143

Other identifiers 2

IdentifierTypeStateIssuer
430047952OtherWIRAILROAD MEDICARE
43379000MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080619000337 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557432580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grant Regional Health Center IncGroup PAC ID 9638079445, 36 clinicians

Practice addresses (Care Compare)

507 S Monroe St
Lancaster, WI 53813-2054
Phone (608) 723-2131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110438-030WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Grant Regional Health Center, Inc. CurrentSince Feb 14, 2011 Accepting new patients
Grant Regional Health Center, Inc CurrentSince Feb 14, 2011 Accepting new patients

Locations

507 S Monroe St
Lancaster, WI 53813
Phone (608) 723-2131

Interoperability endpoints

  • Direct secure messaging: mbainbridge847500@direct.unitypoint.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1073518601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S MONROE ST",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538132054",
            "telephone_number": "608-723-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 S MONROE ST",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538132054",
            "telephone_number": "608-723-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINBRIDGE",
        "first_name": "MICHELLE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "110438-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430047952",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43379000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.