Individual provider Active NPI

Alyssa Jezowski, CRNA

  • Certified Registered Nurse Anesthetist
  • Ypsilanti, MI
National Provider Identifier
1245894351
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704307410 Issued in MI
Practice address
Sjmhs-Trinity Health Ann Arbor
5301 E Huron River Drive
Ypsilanti, MI 48197
Phone
(734) 712-3456
Fax
(734) 712-0133
NPI assigned
Apr 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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 4704307410 MI Primary

Addresses

Primary practice location

Sjmhs-Trinity Health Ann Arbor
5301 E Huron River Drive
Ypsilanti, MI 48197

Mailing address

2006 Hogback Rd.
Suite 5 a
Ann Arbor, MI 48105
Phone (734) 712-3456

Other names 1

  • Alyssa Achacon Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Jennifer.Tomkinson@trinity-health.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190823000242 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880922210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sjmhs Anesthesia ServicesGroup PAC ID 7416053483, 103 clinicians

Practice addresses (Care Compare)

5301 E Huron River Dr
Ypsilanti, MI 48197-1051
Phone (734) 712-3456

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704307410MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sjmhs Anesthesia Services Nurse Anesthetist, Certified Registered CurrentSince Jul 15, 2019 Accepting new patients
Sjmhs Anesthesia Services Nurse Anesthetist, Certified Registered CurrentSince Jul 15, 2019 Accepting new patients
Sjmhs Anesthesia Services Current Accepting new patients
Sjmhs Anesthesia Services Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2006 Hogback Rd
Ste 5A
Ann Arbor, MI 48105
Phone (734) 786-2317

7575 Grand River Rd
Brighton, MI 48114
Phone (810) 844-7544

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

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": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1245894351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 HOGBACK RD.",
            "address_2": "SUITE 5 A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-712-3456",
            "fax_number": "734-712-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SJMHS-TRINITY HEALTH ANN ARBOR",
            "address_2": "5301 E HURON RIVER DRIVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48197",
            "telephone_number": "734-712-3456",
            "fax_number": "734-712-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEZOWSKI",
        "first_name": "ALYSSA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704307410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jennifer.Tomkinson@trinity-health.org",
            "affiliation": "N",
            "address_1": "5301 McAuley Dr",
            "city": "Ypsilanti",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481971051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "ACHACON",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.