NPIMap

Organization Active NPI

Sjmhs Anesthesia Services

  • Anesthesiology Physician
  • Ypsilanti, MI
National Provider Identifier
1508201617
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SJMHS ANESTHESIA SERVICES
Practice address
5301 E Huron River Dr
Ypsilanti, MI 48197-1051
Phone
(734) 712-3456
NPI assigned
May 2, 2013
Organization subpart
Yes
Parent organization
TRINITY HEALTH MIAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Authorized official

Name
Garry Faja
Title
President, Ceo Sjmhs
Phone
(734) 712-3456

Specialties & licenses 1

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

Addresses

Primary practice location

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

Mailing address

5301 E Huron River Dr
MC 69504
Ypsilanti, MI 48197-1051
Phone (734) 712-3456

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070508000487 MI Part B Supplier - Clinic/Group Practice 7416053483 Receives reassigned benefits from 149 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brighton, MI; Ypsilanti, MI

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Mercy Health Services

Practitioners & affiliated clinicians

Practitioners 8

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": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1508201617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 E HURON RIVER DR",
            "address_2": "MC 69504",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E HURON RIVER DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJMHS ANESTHESIA SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY HEALTH MI",
        "enumeration_date": "2013-05-02",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "FAJA",
        "authorized_official_first_name": "GARRY",
        "authorized_official_title_or_position": "PRESIDENT, CEO SJMHS",
        "authorized_official_telephone_number": "734-712-3456"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.