Individual provider Active NPI

Tara Lynn Kautzer, CRNA

  • Certified Registered Nurse Anesthetist
  • Ann Arbor, MI
National Provider Identifier
1104003862
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704239859 Issued in MI
Practice address
2006 Hogback Rd Ste 5a
Ann Arbor, MI 48105-9750
Phone
(734) 263-2417
NPI assigned
Jan 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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 4704239859 MI Primary

Addresses

Primary practice location

2006 Hogback Rd Ste 5a
Ann Arbor, MI 48105-9750

Mailing address

3911 Rochester Rd
Troy, MI 48083-5246
Phone (248) 689-7740

Other practice location 1

4550 Investment Dr Ste 100
Troy, MI 48098-6334
Phone (248) 265-4600

Other names 1

  • Tara Lynn Meredith Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080404000120 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052498805 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Lake Anesthesiology Consultants PLCGroup PAC ID 7113818980, 94 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704239859MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Straith Hospital for Special Surgery Nurse Anesthetist, Certified Registered CurrentSince Jul 25, 2017 Accepting new patients
Waterford Anesthesia, PLLC CurrentSince Jun 15, 2010 Accepting new patients
Superior Anesthetists Associates, Inc. CurrentSince Feb 1, 2018 Accepting new patients
Anesthesia Associates of Ann Arbor, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2024 Accepting new patients
Straith Hospital for Special Surgery CurrentSince Jul 25, 2017 Accepting new patients
Axon Anesthesia Consultants, PLC CurrentSince Mar 6, 2018 Accepting new patients
Environ Anesthesia, LLC. Nurse Anesthetist, Certified Registered CurrentSince Aug 5, 2018 Accepting new patients
Ambulatory Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince Oct 9, 2017 Accepting new patients
Long Lake Anesthesiology Consultants, PLC CurrentSince Aug 1, 2024 Accepting new patients
Straith Hospital for Special Surgery Current Accepting new patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 31, 2020 Accepting new patients
Waterford Surgical Center, LLC Past Accepting new patients
Straith Hospital for Special Surgery Past Accepting new patients

Locations

2009 Momentum Pl
Chicago, IL 60689

949 National Ave
Ste 151
Lexington, KY 40502
Phone (859) 509-8399

2006 Hogback Rd
Ste 5A
Ann Arbor, MI 48105
Phone (734) 786-2317

2006 Hogback Rd
Ste 5
Ann Arbor, MI 48105
Phone (313) 712-4331

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

18100 Oakwood Blvd
Ste 100
Dearborn, MI 48124
Phone (313) 240-7668

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

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

255 W Michigan Ave
Jackson, MI 49201

1375 S Lapeer Rd
Ste 109
Lake Orion, MI 48360
Phone (248) 693-7950

1546 Callis Rd
Lapeer, MI 48446
Phone (810) 667-4000

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

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

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

326 N Main St
Royal Oak, MI 48067
Phone (248) 584-7600

5400 Mackinaw Rd
Ste 6100
Saginaw, MI 48604
Phone (989) 792-3100

23901 Lahser Rd
Southfield, MI 48033
Phone (248) 357-3360

1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001

230 W Maple Rd
Troy, MI 48084
Phone (248) 244-1500

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

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

5220 Highland Rd
Ste 100
Waterford, MI 48327
Phone (248) 461-2800

5220 Highland Rd
Ste 1
Waterford, MI 48327
Phone (248) 886-5555

Organizations & group practices 13

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.

View all 13

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": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1104003862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 ROCHESTER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835246",
            "telephone_number": "248-689-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 HOGBACK RD STE 5A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059750",
            "telephone_number": "734-263-2417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4550 Investment Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480986334",
            "country_code": "US",
            "telephone_number": "248-265-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUTZER",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-24",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704239859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "MEREDITH",
            "middle_name": "LYNN",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 17, 2025; 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.