PSJ Anesthesia PC
Organization Active NPI Certified Registered Nurse Anesthetist · Southfield, MI
NPI 1275905796 · NPPES record last updated Oct 23, 2015
Key facts
- NPI
- 1275905796
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- Legal business name
- PSJ ANESTHESIA PC
- Practice address
- 16001 W 9 Mile Rd
Southfield, MI 48075-4818 - Phone
- (248) 849-3000
- Fax
- (770) 237-1492
- NPI assigned
- Oct 23, 2015
- Organization subpart
- No
Authorized official
- Name
- Dominick Lago, MD
- Title
- President/Owner
- Phone
- (412) 418-6077
Practitioners 213
-
Carol C Adamkiewicz, CRNA
-
Isioma L Aghachi, CRNA
-
Olubukola Akinbiyi, CRNA
-
Gheorghe Alion, CRNA
-
Jordan Alkhalidi, CRNA
-
Paul Thomas Allen, CRNA
-
Jason Mallo Amador, CRNA
-
Jaime T Bagnell-Leonardo, CRNA
-
Michelle M Balancio, CRNA
-
Allison Barrett, CRNA
-
Chelsea Bernas, CRNA
-
Jason Barry Blackburn, CRNA
-
Jon T Braman, CRNA
-
Marisa Bueche, CRNA
-
Carol L Burke, CRNA
-
Andrea Donessa Caldwell, CRNA
-
Leslie Cardwell, CRNA
-
Eric Caron, CRNA
-
Kimberly Carpenter, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160210000814 | MI | Part B Supplier - Clinic/Group Practice | 8325342488 |
Receives reassigned benefits from 209 practitioners Practice locations: Novi, MI; Southfield, MI |
National Provider Directory
Locations
30400 Telegraph Rd
Ste 405
Bingham Farms, MI 48025
Phone (248) 483-8138
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist |
367500000X | Yes |
Addresses
Primary practice location
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Mailing address
30400 Telegraph Rd
Suite 405
Bingham Farms, MI 48025-4537
Phone (412) 418-6077
Other providers in Southfield, MI
- Talia Onay Pruiett
- Alexis Pruitt
- Jamarr A Pruitt
- Renee M Przeslawski
- Kelly Maureen Pseres
- Psychiatric Associates PC
- Psychological Assets PC
- Victoria Puchalski
- Gabriela Puente-Solorio
- Maria Puente-Solorios
All providers in Southfield, MI · Certified Registered Nurse Anesthetist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.