Organization Active NPI

Novi Orthopedic Anesthesia Specialists, P.C.

  • Anesthesiology Physician
  • Novi, MI
National Provider Identifier
1508054966
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NOVI ORTHOPEDIC ANESTHESIA SPECIALISTS, P.C.
Practice address
48201 Grand River Ave
Suite 100
Novi, MI 48374-1242
Phone
(800) 853-8989
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Dominick Lago Jr., MD
Title
Authorized Representative
Phone
(800) 853-8989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

48201 Grand River Ave
Suite 100
Novi, MI 48374-1242

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (800) 853-8989

National Provider Directory

National Provider Directory

Locations

48201 Grand River Ave
Ste 100
Novi, MI 48374
Phone (800) 853-8989

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1508054966",
    "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": "800-853-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48201 GRAND RIVER AVE",
            "address_2": "SUITE 100",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741242",
            "telephone_number": "800-853-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVI ORTHOPEDIC ANESTHESIA SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "LAGO",
        "authorized_official_first_name": "DOMINICK",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "800-853-8989",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.