Individual provider Active NPI

Chad Michael Roberts, CRNA

  • Certified Registered Nurse Anesthetist
  • Ann Arbor, MI
National Provider Identifier
1619083011
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704221969 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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 4704221969 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (810) 606-6499

Other identifiers 1

IdentifierTypeStateIssuer
4624504MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811001068 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042282832 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sjmhs Anesthesia ServicesGroup PAC ID 7416053483, 103 clinicians

Practice addresses (Care Compare)

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

7555 Grand River Rd
Brighton, MI 48114-9338
Phone (810) 854-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sjmhs Anesthesia Services Nurse Anesthetist, Certified Registered CurrentSince May 17, 2020 Accepting new patients
Sjmhs Anesthesia Services Nurse Anesthetist, Certified Registered CurrentSince May 17, 2020 Accepting new patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince May 1, 2019 Accepting new patients
Sjmhs Anesthesia Services Current Accepting new patients
Long Lake Anesthesiology Consultants, PLC CurrentSince Sep 1, 2024 Accepting new patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2013 Accepting new patients
Henry Ford Health Genesys Hospital Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2008 Accepting new patients
Ascension Genesys Hospital CurrentSince Jul 1, 2008 Accepting new patients
American Anesthesiology Associates of Michigan, PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2009 Momentum Pl
Chicago, IL 60689

7794 Solution Ctr
Chicago, IL 60677

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

5701 Bow Pointe Dr
Ste 145
Clarkston, MI 48346
Phone (248) 922-4800

1121 W Hill Rd
Flint, MI 48507
Phone (810) 232-8888

501 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-4800

1 Genesys Pkwy
#H
Grand Blanc, MI 48439

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

1707 Lake Lansing Rd
Lansing, MI 48912
Phone (517) 267-0033

3400 E Jolly Rd
Lansing, MI 48910
Phone (517) 272-1063

26750 Providence Pkwy
Ste 100
Novi, MI 48374
Phone (248) 662-1500

920 River Centre Dr
Port Huron, MI 48060
Phone (810) 984-5200

1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001

4550 Investment Dr
Ste 100
Troy, MI 48098
Phone (248) 265-4600

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4

Organizations & group practices 9

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1619083011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Genesys Pkwy",
            "address_purpose": "LOCATION",
            "city": "Grand Blanc",
            "state": "MI",
            "postal_code": "484398065",
            "country_code": "US",
            "telephone_number": "810-606-6499",
            "fax_number": "810-606-7245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CHAD",
        "middle_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704221969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4624504",
            "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 Jul 12, 2019; 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.