Individual provider Active NPI

Maria Elena McCusker, CRNA

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1548459373
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704220795 Issued in MI
Practice address
4646 John R
Detroit, MI 48201
Phone
(313) 576-1000
NPI assigned
Oct 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704220795 MI Primary

Addresses

Primary practice location

4646 John R
Detroit, MI 48201

Mailing address

2929 Shirley St
Milford, MI 48380-2244
Phone (248) 685-0609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090316000509 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173680337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-4100

Hospital & facility affiliations

  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704220795MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford West Bloomfield Hospital Nurse Anesthetist, Certified Registered Current Accepting new patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Apr 9, 2020 Accepting new patients
Henry Ford West Bloomfield Hospital CurrentSince Mar 1, 2010 Accepting new patients
Henry Ford Health System CurrentSince Apr 9, 2020 Accepting new patients
Saint Joseph Mercy Livingston Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Interoperability endpoints

  • Direct secure messaging: mmccusker13527@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1548459373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 SHIRLEY ST",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483802244",
            "telephone_number": "248-685-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 JOHN R",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-576-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUSKER",
        "first_name": "MARIA",
        "middle_name": "ELENA",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704220795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.