Individual provider Active NPI

Michael David Hogue, CRNA

  • Certified Registered Nurse Anesthetist
  • Newark, DE
National Provider Identifier
1083079990
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
L6-0A00749 Issued in DE
Practice address
4735 Ogletown-Stanton Road
Newark, DE 19718
Phone
(302) 733-1000
Fax
(302) 623-2593
NPI assigned
Dec 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN610176 PA
Registered Nurse 163W00000X L1-0047862 DE
Certified Registered Nurse Anesthetist 367500000X L6-0A00749 DE Primary

Addresses

Primary practice location

4735 Ogletown-Stanton Road
Newark, DE 19718

Mailing address

2 Reads Way
Suite 201
New Castle, DE 19720-1630
Phone (302) 709-4510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230815003233 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234434473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

890 Oak St SE
Salem, OR 97301-3905
Phone (503) 561-5200

Hospital & facility affiliations

  • Salem Hospital Hospital, Salem, OR, CCN 380051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1-0047862DEMDRegistered Nurse
RN610176PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health CurrentSince Jul 31, 2023 Accepting new patients
Salem Health CurrentSince Jul 31, 2023 Accepting new patients
Salem Health Current Accepting new patients

Locations

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

890 Oak St SE
Salem, OR 97301
Phone (503) 585-0830

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 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": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1083079990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 READS WAY",
            "address_2": "SUITE 201",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197201630",
            "telephone_number": "302-709-4510",
            "fax_number": "302-356-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN-STANTON ROAD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19718",
            "telephone_number": "302-733-1000",
            "fax_number": "302-623-2593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGUE",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-18",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN610176",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0047862",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "DE",
            "license": "L6-0A00749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.