Individual provider Active NPI

Lisa A O'Hagan, CRNA

  • Certified Registered Nurse Anesthetist
  • Dearborn, MI
National Provider Identifier
1275640377
Registry record updated Dec 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704207438 Issued in MI
Practice address
18101 Oakwood Blvd
Anesthesia Dept
Dearborn, MI 48124-4089
Phone
(313) 593-7820
Fax
(313) 593-8894
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2008

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 4704207438 MI Primary

Addresses

Primary practice location

18101 Oakwood Blvd
Anesthesia Dept
Dearborn, MI 48124-4089

Mailing address

18101 Oakwood Blvd
Anesthesia Dept
Dearborn, MI 48124-4089
Phone (313) 593-7820

Other identifiers 1

IdentifierTypeStateIssuer
4539225MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090309000272 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810053303 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians
West Michigan Aas LLCGroup PAC ID 9931324076, 38 clinicians

Practice addresses (Care Compare)

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (214) 687-0001

25500 Meadowbrook Rd
Suite 110
Novi, MI 48375-1879
Phone (248) 477-2200

Hospital & facility affiliations

  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Aas LLC CurrentSince Sep 6, 2023 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2020 Accepting new patients
Michigan Crnas Staffing LLC CurrentSince Sep 1, 2023 Accepting new patients
St. Joseph Mercy Hospital Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

4024 Park East Ct SE
Grand Rapids, MI 49546
Phone (231) 592-3102

3800 Centennial Dr
Grass Lake, MI 49240
Phone (517) 701-3100

26750 Providence Pkwy
Ste 100
Novi, MI 48374
Phone (248) 662-1500

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

25500 Meadowbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 477-0220

1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001

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

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 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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229644800000",
    "number": "1275640377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "address_2": "ANESTHESIA DEPT",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7820",
            "fax_number": "313-593-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "address_2": "ANESTHESIA DEPT",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7820",
            "fax_number": "313-593-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HAGAN",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704207438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4539225",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; 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.