Individual provider Active NPI

Michelle Grant, CRNA

  • Certified Registered Nurse Anesthetist
  • Bangor, ME
National Provider Identifier
1467550376
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
043498 Issued in ME
Practice address
489 State St
Bangor, ME 04401-6616
Phone
(207) 973-4519
Fax
(207) 992-4132
NPI assigned
Sep 21, 2006
Last updated
Mar 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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 043498 ME Primary

Addresses

Primary practice location

489 State St
Bangor, ME 04401-6616

Mailing address

141 N Main St Ste 205
Brewer, ME 04412-2055
Phone (207) 973-4519

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050103000508 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587622808 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

Merit-based Incentive Payment System (MIPS)

Final score
89.98 of 100Reported as group
Quality
74.88
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043498MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
True North Anesthesia L.L.C. Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2018 Accepting new patients
Sebasticook Valley Health CurrentSince Jan 13, 2018 Accepting new patients
Sebasticook Valley Health CurrentSince Jan 13, 2018 Accepting new patients
Maine Eye Care Associates CurrentSince Jan 15, 2014 Accepting new patients
Eastern Maine Medical Center CurrentSince Dec 1, 2004 Accepting new patients
Eastern Maine Medical Center CurrentSince Dec 1, 2004 Accepting new patients

Locations

455 Harlow St
Bangor, ME 04401
Phone (207) 992-4032

489 State St
Bangor, ME 04401
Phone (207) 973-8837

141 N Main St
Ste 205
Brewer, ME 04412
Phone (207) 992-4032

447 N Main St
Pittsfield, ME 04967
Phone (207) 487-0981

325A Kennedy Memorial Dr
Waterville, ME 04901
Phone (207) 667-9690

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1467550376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N MAIN ST STE 205",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044122055",
            "telephone_number": "207-973-4519",
            "fax_number": "207-992-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-4519",
            "fax_number": "207-992-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "MICHELLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "043498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.