Active NPI
Robert D Scibiorski, CRNA
- Certified Registered Nurse Anesthetist
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704271870
- Practice address
- 3990 John R St
Detroit, MI 48201-2018 - Phone
- (313) 745-7600
- Fax
- (952) 442-3620
- NPI assigned
- Dec 23, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704271870 | MI | Primary |
Addresses
Primary practice location
3990 John R St
Detroit, MI 48201-2018
Mailing address
4676 Department
Carol Stream, IL 60122-4676
Phone (952) 442-9770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2799 W Grand Boulevard
Detroit, MI 48202-2608
Phone (313) 916-2600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704271870 | MI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Michigan PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Wyandotte Hospital | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Henry Ford Health System | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Henry Ford Wyandotte Hospital | Current | Accepting new patients |
Locations
4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615
3990 John R St
Detroit, MI 48201
Phone (313) 745-6211
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953
2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000
Interoperability endpoints
- rscibiorski389179@direct.hfhs.org
Organizations & group practices 5
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.
-
- Certified Registered Nurse Anesthetist
- Detroit, MI
- NPI 1871666479
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Wyandotte, MI
- NPI 1386685212
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Irving, TX
- NPI 1871986372
MI, Nurse Anesthetist, Certified Registered
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
-
dba Henry Ford Health Center-Brownstown Pharmacy
- Community/Retail Pharmacy
- Brownstown TWP, MI
- NPI 1356356984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419292800000",
"number": "1104214329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4676 DEPARTMENT",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "601224676",
"telephone_number": "952-442-9770",
"fax_number": "952-442-3620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3990 JOHN R ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012018",
"telephone_number": "313-745-7600",
"fax_number": "952-442-3620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCIBIORSKI",
"first_name": "ROBERT",
"middle_name": "D",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-23",
"last_updated": "2014-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704271870",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.