Active NPI
Frederick J Lazaga, CRNA
- Certified Registered Nurse Anesthetist
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704152373
- Practice address
- 7733 E Jefferson Ave
Detroit, MI 48214-3707 - Phone
- (313) 499-4254
- NPI assigned
- Aug 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704152373 | MI | Primary |
Addresses
Primary practice location
7733 E Jefferson Ave
Detroit, MI 48214-3707
Mailing address
7733 E Jefferson Ave
Detroit, MI 48214-3707
Phone (313) 499-4254
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3402127 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1996
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
33155 Annapolis St
Wayne, MI 48184-2405
Phone (214) 687-0001
Hospital & facility affiliations
- Beaumont Hospital, Troy
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704152373 | MI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William Beaumont Hospital | Current | Accepting new patients | |
| Northstar Anesthesia of Michigan III PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| William Beaumont Hospital | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000
3601 W 13 Mile Rd
Royal Oak, MI 48073
130 Town Center Dr
Ste 203
Troy, MI 48084
Phone (248) 585-8250
33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042
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.
-
- Pain Medicine (Anesthesiology) Physician
- Irving, TX
- NPI 1972126209
MI, Nurse Anesthetist, Certified Registered
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1811044878
Nurse Anesthetist, Certified Registered
-
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194734012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7733 E JEFFERSON AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482143707",
"telephone_number": "313-499-4254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7733 E JEFFERSON AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482143707",
"telephone_number": "313-499-4254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZAGA",
"first_name": "FREDERICK",
"middle_name": "J",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704152373",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3402127",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.