Individual provider Active NPI

Jeffrey M Kirby

  • Certified Registered Nurse Anesthetist
  • Clinton TWP, MI
National Provider Identifier
1114566189
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704310692 Issued in MI
Practice address
15855 19 Mile Rd
Clinton TWP, MI 48038-3504
Phone
(586) 263-2300
NPI assigned
Dec 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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 4704310692 MI Primary

Addresses

Primary practice location

15855 19 Mile Rd
Clinton TWP, MI 48038-3504

Mailing address

436 Indian Lake CT
Lake Orion, MI 48362-1667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200319001476 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517395866 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester Medical Associates PLLCGroup PAC ID 8729318704, 23 clinicians
Henry Ford Macomb Hospital CorporationGroup PAC ID 7911808381, shared by 5 NPIs, 349 clinicians
Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Practice addresses (Care Compare)

1349 S Rochester Rd
Suite 150
Rochester Hills, MI 48307-3152
Phone (248) 844-3800

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

3337 Britton Rd
Perry, MI 48872-9706
Phone (517) 625-3004

721 N Shiawassee St
Owosso, MI 48867-1632

826 W King St
Owosso, MI 48867-2120

Hospital & facility affiliations

  • Memorial Healthcare Hospital, Owosso, MI, CCN 230121
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2020 Accepting new patients
Henry Ford Macomb Hospital Corporation Current Accepting new patients
Rochester Medical Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2021 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Feb 3, 2020 Accepting new patients
Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients
Henry Ford Macomb Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2025 Accepting new patients
Henry Ford Health System CurrentSince Dec 1, 2020 Accepting new patients
Henry Ford Macomb Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Feb 3, 2020 Accepting new patients
Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients

Locations

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

30795 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 421-3000

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

1349 S Rochester Rd
Ste 150
Rochester Hills, MI 48307
Phone (248) 844-3800

14500 Hall Rd
Sterling Hts, MI 48313
Phone (586) 247-2700

Interoperability endpoints

  • Direct secure messaging: jkirby525335@direct.hfhs.org

Organizations & group practices 10

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 3

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": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1114566189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 INDIAN LAKE CT",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483621667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704310692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.