Individual provider Active NPI

Edward Wozniak

  • Certified Registered Nurse Anesthetist
  • Ann Arbor, MI
National Provider Identifier
1083002737
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704269810 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Jan 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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 4704269810 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150216001774 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032434055 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Eastern District Anesthesiology PLLCGroup PAC ID 6507195419, 40 clinicians
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians
Long Lake Anesthesiology Consultants PLCGroup PAC ID 7113818980, 94 clinicians

Practice addresses (Care Compare)

1349 S Rochester Rd
250 Orthopaedic Surgical Institute
Rochester Hills, MI 48307-3186
Phone (248) 601-0040

33155 Annapolis St
Wayne, MI 48184-2405
Phone (214) 687-0001

4550 Investment Dr
Troy, MI 48098-6334
Phone (248) 265-4600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
William Beaumont Hospital CurrentSince Jan 15, 2015 Accepting new patients
Superior Anesthetists Associates, Inc. CurrentSince Jan 11, 2023 Accepting new patients
William Beaumont Hospital Nurse Anesthetist, Certified Registered CurrentSince Jan 15, 2015 Accepting new patients
Long Lake Anesthesiology Consultants, PLC CurrentSince Aug 1, 2024 Accepting new patients
Eastern District Anesthesiology PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 17, 2023 Accepting new patients

Locations

2009 Momentum Pl
Chicago, IL 60689

5701 Bow Pointe Dr
Ste 145
Clarkston, MI 48346
Phone (248) 922-4800

5202 Miller Rd
Flint, MI 48507
Phone (810) 720-8900

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

920 River Centre Dr
Port Huron, MI 48060
Phone (810) 984-5200

1349 S Rochester Rd
Ste 250
Rochester Hills, MI 48307
Phone (248) 601-0040

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

3601 W 13 Mile Rd
Royal Oak, MI 48073

29110 Inkster Rd
Ste 100
Southfield, MI 48034
Phone (248) 234-9300

4550 Investment Dr
Troy, MI 48098
Phone (248) 265-4600

4550 Investment Dr
Ste 100
Troy, MI 48098
Phone (248) 265-4600

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Organizations & group practices 6

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 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": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1083002737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOZNIAK",
        "first_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-05",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704269810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.