Individual provider Active NPI

Abigail Callejo-Covacha, CRNA

  • Certified Registered Nurse Anesthetist
  • Troy, MI
National Provider Identifier
1407822323
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704202474 Issued in MI
Practice address
44201 Dequindre Rd
400 FSC - PCS
Troy, MI 48085-1198
Phone
(248) 423-3144
NPI assigned
Feb 28, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 4704202474 MI Primary

Addresses

Primary practice location

44201 Dequindre Rd
400 FSC - PCS
Troy, MI 48085-1198

Mailing address

3601 W 13 Mile Rd
400 FSC - PCS
Royal Oak, MI 48073-6769
Phone (248) 423-3144

Other identifiers 1

IdentifierTypeStateIssuer
4651440MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041202000691 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365408283 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians
Long Lake Anesthesiology Consultants PLCGroup PAC ID 7113818980, 94 clinicians

Practice addresses (Care Compare)

44201 Dequindre Rd
Nsa of Michigan III PLLC
Troy, MI 48085-1117
Phone (214) 687-0001

4550 Investment Dr
Troy, MI 48098-6334
Phone (248) 265-4600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Long Lake Anesthesiology Consultants, PLC CurrentSince Aug 1, 2024 Accepting new patients
William Beaumont Hospital Nurse Anesthetist, Certified Registered CurrentSince Sep 14, 2004 Accepting new patients
Superior Anesthetists Associates, Inc. CurrentSince Apr 7, 2018 Accepting new patients
William Beaumont Hospital CurrentSince Sep 14, 2004 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Apex Anesthesia Services PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2009 Momentum Pl
Chicago, IL 60689

5701 Bow Pointe Dr
Ste 145
Clarkston, MI 48346
Phone (248) 922-4800

18100 Oakwood Blvd
Ste 100
Dearborn, MI 48124
Phone (313) 240-7668

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

5202 Miller Rd
Flint, MI 48507
Phone (810) 720-8900

920 River Centre Dr
Port Huron, MI 48060
Phone (810) 984-5200

3601 W 13 Mile Rd
Royal Oak, MI 48073

3601 W 13 Mile Rd
#400
Royal Oak, MI 48073
Phone (248) 423-2481

29110 Inkster Rd
Ste 100
Southfield, MI 48034
Phone (248) 234-9300

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

44201 Dequindre Rd
#400
Troy, MI 48085
Phone (248) 423-3144

4550 Investment Dr
Troy, MI 48098
Phone (248) 265-4600

4550 Investment Dr
Ste 100
Troy, MI 48098
Phone (248) 265-4600

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

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407822323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "address_2": "400 FSC - PCS",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736769",
            "telephone_number": "248-423-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44201 DEQUINDRE RD",
            "address_2": "400 FSC - PCS",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851198",
            "telephone_number": "248-423-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLEJO-COVACHA",
        "first_name": "ABIGAIL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704202474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4651440",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.