Individual provider Active NPI

Michelle M Balancio, CRNA

  • Certified Registered Nurse Anesthetist
  • Southfield, MI
National Provider Identifier
1144325192
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704168195 Issued in MI
Practice address
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone
(248) 849-5806
Fax
(248) 849-5489
NPI assigned
Sep 14, 2006
Last updated
Jan 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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 4704168195 MI Primary

Addresses

Primary practice location

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Mailing address

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-5806

Other identifiers 3

IdentifierTypeStateIssuer
3392227MedicaidMI
11909375OtherCAQH
F36455230OtherCRITTENTON MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050527000457 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234171455 Reassigns benefits to 4 organizations
I20240417000073 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234171455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

Practice addresses (Care Compare)

110 W Underwood St
Suite B
Orlando, FL 32806-1139
Phone (407) 648-9151

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704168195MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 10, 2024 Accepting new patients
PSJ Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2016 Accepting new patients
The Center for Gastrointestinal Health at Health Park LLC CurrentSince Sep 1, 2017 Accepting new patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 10, 2024 Accepting new patients
GLPS Staffing Solutions LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2014 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 28, 2022 Accepting new patients
St. Joseph Mercy Hospital Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients
Henry Ford Health Providence Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

206 2nd St E
Bradenton, FL 34208
Phone (941) 745-7202

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

4571 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 333-2050

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

9035 Sunset Dr
Ste 200
Miami, FL 33173
Phone (786) 615-6210

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

110 Underwood St
Ste B
Orlando, FL 32806
Phone (407) 342-5842

1881 W Kennedy Blvd
Ste C
Tampa, FL 33606
Phone (813) 693-5000

600 Health Park Blvd
Ste E
Grand Blanc, MI 48439
Phone (810) 503-8210

1375 N Main St
Lapeer, MI 48446
Phone (810) 667-5500

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

3601 W 13 Mile Rd
Royal Oak, MI 48073

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Organizations & group practices 8

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.

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1144325192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-5806",
            "fax_number": "248-849-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-5806",
            "fax_number": "248-849-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALANCIO",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704168195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3392227",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11909375",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRITTENTON MEDICARE PTAN",
            "identifier": "F36455230",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.