Individual provider Active NPI

Stefanie Domanico, CRNA

  • Certified Registered Nurse Anesthetist
  • Novi, MI
National Provider Identifier
1427590751
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704292372 Issued in MI
Practice address
46325 W Twelve Mile Rd Ste 100
Novi, MI 48377-2457
Phone
(248) 618-2121
NPI assigned
Nov 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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 4704292372 MI Primary

Addresses

Primary practice location

46325 W Twelve Mile Rd Ste 100
Novi, MI 48377-2457

Mailing address

2544 Spindlehill Dr Apt 5
Cincinnati, OH 45230-1047
Phone (248) 515-3507

Other names 1

  • Stefanie Burdalas Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170228000279 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698059228 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
GLPS Staffing Solutions LLCGroup PAC ID 2365668043, 8 clinicians
Anesthesia Associates of Ann Arbor PLLCGroup PAC ID 1355317223, 213 clinicians

Practice addresses (Care Compare)

1000 Harrington St
Mount Clemens, MI 48043-2920
Phone (586) 493-8000

2006 Hogback Rd
Ann Arbor, MI 48105-9750

230 W Maple Rd
Troy, MI 48084-5471
Phone (248) 244-1500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704292372MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novi Aas LLC CurrentSince Mar 1, 2026 Accepting new patients
GLPS Staffing Solutions LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
West Michigan Aas LLC CurrentSince Sep 1, 2025 Accepting new patients
PSJ Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Feb 13, 2017 Accepting new patients
Southfield Rehabilitation Company CurrentSince Jun 2, 2018 Accepting new patients
Southfield Rehabilitation Company Nurse Anesthetist, Certified Registered CurrentSince Jun 2, 2018 Accepting new patients
Anesthesia Associates of Ann Arbor, PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2025 Accepting new patients
American Surgical Centers - Ann Arbor LLC CurrentSince Dec 27, 2025 Accepting new patients

Locations

2006 Hogback Rd
Ste 5
Ann Arbor, MI 48105
Phone (313) 712-4331

710 Avis Dr
Ste 100
Ann Arbor, MI 48108
Phone (734) 719-8900

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

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

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

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

46325 W Twelve Mile Rd
Ste 100
Novi, MI 48377
Phone (248) 618-2121

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

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

22401 Foster Winter Dr
Southfield, MI 48075
Phone (248) 423-4100

230 W Maple Rd
Troy, MI 48084
Phone (248) 244-1500

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1427590751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2544 SPINDLEHILL DR APT 5",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452301047",
            "telephone_number": "248-515-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46325 W TWELVE MILE RD STE 100",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772457",
            "telephone_number": "248-618-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMANICO",
        "first_name": "STEFANIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704292372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "BURDALAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.