Active NPI
Ada Beth Kusnetz, M.D.
- Anesthesiology Physician
- Warren, MI
National Provider Identifier
1477589760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4301053043
- Practice address
- 21230 Dequindre Rd
Warren, MI 48091-2279 - Phone
- (586) 427-1000
- NPI assigned
- Jun 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 4301053043 | MI | Primary |
Addresses
Primary practice location
21230 Dequindre Rd
Warren, MI 48091-2279
Mailing address
255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301053043 | MI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakes Anesthesia, PLC | Anesthesiology | Past | Accepting new patients |
| Michigan Interventional Pain Associates PLLC | Anesthesiology | Past | Accepting new patients |
| The Berry Center, LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
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- Anesthesiology Physician
- Farmington Hills, MI
- NPI 1144261967
-
- Anesthesiology Physician
- West Bloomfield, MI
- NPI 1861819161
-
- Ambulatory Surgical Clinic/Center
- Farmington Hills, MI
- NPI 1316994122
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1477589760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 W MICHIGAN AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012218",
"telephone_number": "517-787-6440",
"fax_number": "517-787-4146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21230 DEQUINDRE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480912279",
"telephone_number": "586-427-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUSNETZ",
"first_name": "ADA",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-25",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301053043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.