Jody D Tavalieri, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704165288 Issued in MI

Practice address

22101 Moross Rd
Detroit, MI 48236-2148

Phone

(313) 343-4766

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Trillium Anesthesia Services PLLCGroup PAC ID 0941698708, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jtavalieri1155245@direct.hfhs.org

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.

• Henry Ford Health St. John Hospital

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
  • NPI 1598896995

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Trillium Anesthesia Services, PLLC

  • Anesthesiology Physician
  • Clinton Township, MI
  • NPI 1417522848
  Medicare reassignment Care Compare group NPD
• Henry Ford Health System

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
  • NPI 1871666479

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD
• Blue Water Anesthesia Consultants, PC

  • Anesthesiology Physician
  • Clinton Township, MI
  • NPI 1134437684
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477635746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23256 ROBERT JOHN ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVALIERI",
        "first_name": "JODY",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704165288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Winston Tatum, R.D.
• Jeffrey W. Taub, M.D.
• Anam Taufiq
• Taurus Prime LLC
• Nathan Patrick Tausch, MD
• Adrianna Taweel, DO
• Amal Mohammed Tawil
• Tala Fauz Tawil
• Tony Tayar, PHARMD
• Kareem Tayeb

• Certified Registered Nurse Anesthetist in Detroit, MI
• Providers in Detroit, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.