Individual provider Active NPI

Lisa A Kuopus, CRNA

  • Certified Registered Nurse Anesthetist
  • Marquette, MI
National Provider Identifier
1134323942
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704184618 Issued in MI
Practice address
580 W College Ave
Marquette, MI 49855-2705
Phone
(906) 225-3406
Fax
(906) 225-3094
NPI assigned
Jun 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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 4704184618 MI Primary

Addresses

Primary practice location

580 W College Ave
Marquette, MI 49855-2705

Mailing address

32522 County Road 581
Ishpeming, MI 49849-9269
Phone (906) 485-4728

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070726000511 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072614668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology of Marquette, P.C.Group PAC ID 6103851712, 26 clinicians

Practice addresses (Care Compare)

850 W Baraga Ave
Marquette, MI 49855-4550
Phone 9062262569100

Hospital & facility affiliations

  • Uphs Marquette DLP Hospital Hospital, Marquette, MI, CCN 230054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704184618MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology of Marquette, P.C. CurrentSince Jan 1, 2020 Accepting new patients
Acquisition Bell Hospital LLC CurrentSince Aug 29, 2017 Accepting new patients
Acquisition Bell Hospital LLC CurrentSince Aug 29, 2017 Accepting new patients
Marquette General Hospital, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

901 Lakeshore Dr
Ishpeming, MI 49849
Phone (906) 485-2653

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

Organizations & group practices 4

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1134323942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32522 COUNTY ROAD 581",
            "city": "ISHPEMING",
            "state": "MI",
            "postal_code": "498499269",
            "telephone_number": "906-485-4728",
            "fax_number": "906-225-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W COLLEGE AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552705",
            "telephone_number": "906-225-3406",
            "fax_number": "906-225-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUOPUS",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704184618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.