Individual provider Active NPI

Patricia Maslyk, CRNA

  • Certified Registered Nurse Anesthetist
  • Bingham Farms, MI
National Provider Identifier
1306802582
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
6504 Issued in NC
Practice address
30200 Telegraph Rd
Suite 220
Bingham Farms, MI 48025-4502
Phone
(248) 258-5058
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4704109569 MI
Certified Registered Nurse Anesthetist 367500000X 6504 NC Primary

Addresses

Primary practice location

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

Mailing address

2485 Wildbrook Run
Bloomfield Hills, MI 48304-1445

Other identifiers 1

IdentifierTypeStateIssuer
104583475MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan II PC Anesthesiology Past Accepting new patients
Straith Hospital for Special Surgery Past Accepting new patients
Henry Ford Health River District Hospital Anesthesiology Past Accepting new patients
Morgan Medical Management, PC Anesthesiology Past Accepting new patients
St. Joseph Mercy Hospital Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1306802582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 WILDBROOK RUN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483041445"
        },
        {
            "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": "MASLYK",
        "first_name": "PATRICIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4704109569",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "6504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104583475",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.