Individual provider Active NPI

Amanda Marie Roegner

  • Certified Registered Nurse Anesthetist
  • Clinton TWP, MI
National Provider Identifier
1417596396
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704307508 Issued in MI
Practice address
15855 19 Mile Rd
Clinton TWP, MI 48038-3504
Phone
(586) 263-2300
NPI assigned
Dec 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 129603 MI
Certified Registered Nurse Anesthetist 367500000X 4704307508 MI Primary

Addresses

Primary practice location

15855 19 Mile Rd
Clinton TWP, MI 48038-3504

Mailing address

7185 Vista Dr
Shelby Township, MI 48316-5862
Phone (586) 907-7647

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200319002306 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719315084 Reassigns benefits to 6 organizations

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
Rochester Medical Associates PLLCGroup PAC ID 8729318704, 23 clinicians
Henry Ford Macomb Hospital CorporationGroup PAC ID 7911808381, shared by 5 NPIs, 349 clinicians

Practice addresses (Care Compare)

1349 S Rochester Rd
Suite 150
Rochester Hills, MI 48307-3152
Phone (248) 844-3800

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

Hospital & facility affiliations

  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
129603MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Feb 5, 2020 Accepting new patients
Macomb Anesthesia, PC CurrentSince Jan 1, 2021 Accepting new patients
Henry Ford Macomb Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Feb 5, 2020 Accepting new patients
Henry Ford Macomb Hospital Corporation Current Accepting new patients
Henry Ford Macomb Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2025 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 5, 2021 Accepting new patients
Eastern District Anesthesiology PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2021 Accepting new patients
Rochester Medical Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2022 Accepting new patients

Locations

30795 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 421-3000

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

43475 Dalcoma Dr
Ste 100
Clinton Twp, MI 48038
Phone (586) 263-5043

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

1349 S Rochester Rd
Ste 150
Rochester Hills, MI 48307
Phone (248) 844-3800

1349 S Rochester Rd
Ste 250
Rochester Hills, MI 48307
Phone (248) 601-0040

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

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

Interoperability endpoints

  • Direct secure messaging: adisanto621268@direct.hfhs.org

Organizations & group practices 8

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": "1577232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1417596396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7185 VISTA DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483165862",
            "telephone_number": "586-907-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEGNER",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-25",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "129603",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704307508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.