Individual provider Active NPI

Kathryn A Samoray, CRNA

  • Certified Registered Nurse Anesthetist
  • Ann Arbor, MI
National Provider Identifier
1558302091
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704138403 Issued in MI
Practice address
1500 E Medical Center Dr
2ND Floor Taubman Center Recp G
Ann Arbor, MI 48109-0222
Phone
(734) 763-5828
NPI assigned
Jun 8, 2006
Last updated
Feb 1, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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 4704138403 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
2ND Floor Taubman Center Recp G
Ann Arbor, MI 48109-0222

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Other identifiers 3

IdentifierTypeStateIssuer
4311742MedicaidMI
4438438MedicaidMI
4838547MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040924000975 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284603416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chelsea Community HospitalGroup PAC ID 0648171074, 38 clinicians

Practice addresses (Care Compare)

1000 Wall St
Ann Arbor, MI 48105-1912
Phone (734) 936-4000

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

4270 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 936-4000

775 S Main St
Chelsea, MI 48118-1370
Phone (734) 475-1311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsea Community Hospital CurrentSince Feb 1, 2004 Accepting new patients
Regents of the University of Michigan Nurse Anesthetist, Certified Registered CurrentSince Jan 8, 2008 Accepting new patients
Chelsea Community Hospital Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2004 Accepting new patients
Regents of the University of Michigan CurrentSince Jan 8, 2008 Accepting new patients
Garden City Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Ambulatory Anesthesia Associates, PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1500 E Medical Center Dr
Fl 2
Ann Arbor, MI 48109
Phone (734) 936-5738

3621 S State St
#700
Ann Arbor, MI 48108

4270 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 232-3000

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

Interoperability endpoints

  • FHIR API: https://phsfhir.primehealthcare.com/PHS-PRD-FHIR/api/FHIR/R4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1558302091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "address_2": "2ND FLOOR TAUBMAN CENTER RECP G",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481090222",
            "telephone_number": "734-763-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMORAY",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704138403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4311742",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4438438",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4838547",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.