Individual provider Active NPI

Jeremy Joseph Lafave, CRNA

  • Certified Registered Nurse Anesthetist
  • Marquette, MI
National Provider Identifier
1174845374
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704259319 Issued in MI
Practice address
420 W Magnetic St
Anesthesia Department
Marquette, MI 49855-2711
Phone
(906) 225-3595
Fax
(906) 225-3697
NPI assigned
Feb 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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 4704259319 MI Primary

Addresses

Primary practice location

420 W Magnetic St
Anesthesia Department
Marquette, MI 49855-2711

Mailing address

420 W Magnetic St
Anesthesia Department
Marquette, MI 49855-2711
Phone (906) 225-3595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100730000132 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072646850 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Georgetown University School of Medicine, 2009
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

  • Schoolcraft Memorial Hospital Hospital, Manistique, MI, CCN 231303
  • 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
4704259319MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology of Marquette, P.C. CurrentSince Jan 29, 2020 Accepting new patients
Marquette General Hospital, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

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

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

Organizations & group practices 3

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 2

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": "1266278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1174845374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W MAGNETIC ST",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552711",
            "telephone_number": "906-225-3595",
            "fax_number": "906-225-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W MAGNETIC ST",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552711",
            "telephone_number": "906-225-3595",
            "fax_number": "906-225-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFAVE",
        "first_name": "JEREMY",
        "middle_name": "JOSEPH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-16",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704259319",
            "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 Feb 16, 2010; 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.