Individual provider Active NPI

Florence Acosta, CRNA

  • Certified Registered Nurse Anesthetist
  • Royal Oak, MI
National Provider Identifier
1124094271
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704201061 Issued in MI
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6769
Phone
(248) 577-3517
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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 4704201061 MI Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6769

Mailing address

130 Town Center Drive, Ste. 203
Beaumont Medical Staff Affairs
Troy, MI 48084-1744
Phone (248) 585-8216

Other identifiers 2

IdentifierTypeStateIssuer
430F364420OtherMIBCBSM
1124094271MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704201061MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont West Bloomfield ASC LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Beaumont West Bloomfield ASC LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1124094271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TOWN CENTER DRIVE, STE. 203",
            "address_2": "BEAUMONT MEDICAL STAFF AFFAIRS",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841744",
            "telephone_number": "248-585-8216",
            "fax_number": "248-585-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736769",
            "telephone_number": "248-577-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "FLORENCE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704201061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "430F364420",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124094271",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.