Individual provider Active NPI

Clay B Awishes, CRNA

  • Certified Registered Nurse Anesthetist
  • Monroe, MI
National Provider Identifier
1467754267
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704229730 Issued in MI
Practice address
718 N Macomb St
Monroe, MI 48162-7815
Phone
(734) 240-8536
NPI assigned
Nov 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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 APRN.CRNA.12044 OH
Certified Registered Nurse Anesthetist 367500000X 4704229730 MI Primary

Addresses

Primary practice location

718 N Macomb St
Monroe, MI 48162-7815

Mailing address

718 N Macomb St
Monroe, MI 48162-7815
Phone (734) 240-8536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110212000099 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315127099 Reassigns benefits to 1 organization
I20111018000695 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315127099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

5640 N Adrian Hwy
Adrian, MI 49221-8318
Phone (419) 291-4491

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704229730MIMDCertified Registered Nurse Anesthetist
APRN.CRNA.12044OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Jan 4, 2022 Accepting new patients
Promedica Central Physicians CurrentSince Jan 4, 2022 Accepting new patients
Mercy Memorial Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Nov 21, 2017 Accepting new patients
Promedica Central Corporation of Michigan CurrentSince May 1, 2023 Accepting new patients
Mercy Memorial Hospital Corporation CurrentSince Nov 21, 2017 Accepting new patients
Ambulatory Anesthesia Associates, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Eastriver Anesthesia Services, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Stephen J. Watts, MD, PLLC Past Accepting new patients

Locations

5640 N Adrian Hwy
Adrian, MI 49221
Phone (419) 291-3000

3175 Smith Rd
Lambertville, MI 48144
Phone (734) 856-5494

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

200 E Russell Rd
Unit C
Tecumseh, MI 49286
Phone (517) 424-3883

2600 Navarre Ave
Fl 3
Oregon, OH 43616
Phone (419) 696-7701

2600 Navarre Ave
Oregon, OH 43616
Phone (419) 696-7200

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1291075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1467754267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 N MACOMB ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481627815",
            "telephone_number": "734-240-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 N MACOMB ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481627815",
            "telephone_number": "734-240-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWISHES",
        "first_name": "CLAY",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-30",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.12044",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704229730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.