Julie Staczek-Marx, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704192607 Issued in MI

Practice address

30200 Telegraph Rd
Suite 220
Bingham Farms, MI 48025-4502

Phone

(248) 258-5058

NPI assigned

Apr 28, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians

Asa Staffing IncGroup PAC ID 3971898644, 146 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jstaczekmarx1152220@direct.hfhs.org

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.

• Asa Staffing Inc

  • Certified Registered Nurse Anesthetist
  • Rochester, MI
  • NPI 1114378981

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Henry Ford Health Providence Hospital

  • Certified Registered Nurse Anesthetist
  • Southfield, MI
  • NPI 1851339196

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Macomb Endoscopy Center PLC

  • Ambulatory Surgical Clinic/Center
  • Macomb, MI
  • NPI 1780923128
  Medicare reassignment NPD
• Northwestern Services, LLC

  • Certified Registered Nurse Anesthetist
  • Farmington Hills, MI
  • NPI 1215106679

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• PSJ Anesthesia PC

  • Certified Registered Nurse Anesthetist
  • Southfield, MI
  • NPI 1275905796

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Superior Anesthetists Associates, Inc.

  • Specialist
  • Troy, MI
  • NPI 1831144518
  Medicare reassignment NPD
• Surgical Centers of Michigan, LLC.

  • Ambulatory Surgical Clinic/Center
  • Troy, MI
  • NPI 1962463133
  Medicare reassignment NPD
• Northstar Anesthesia of Michigan II PC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1437268026

  MI, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Henry Ford Health Providence Hospital

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1265497226
  NPD
• Macomb Endoscopy Center, PLC

  • Anesthesiology Physician
  • Macomb, MI
  • NPI 1821498536
  NPD
• Northwestern Services, LLC

  • Anesthesiology Physician
  • Farmington Hills, MI
  • NPI 1083883649
  NPD
• Surgical Centers of Michigan, LLC

  • Anesthesiology Physician
  • Troy, MI
  • NPI 1518367234
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1235196643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 MARIE CIR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30200 TELEGRAPH RD",
            "address_2": "SUITE 220",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254502",
            "telephone_number": "248-258-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACZEK-MARX",
        "first_name": "JULIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704192607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00311212",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104624415",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; 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.