Individual provider Active NPI

Eva Ross, CRNA

  • Certified Registered Nurse Anesthetist
  • Rochester Hills, MI
National Provider Identifier
1629372495
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704253168 Issued in MI
Practice address
2450 Walton Blvd
Rochester Hills, MI 48309-1481
Phone
(248) 650-0096
Fax
(224) 255-5813
NPI assigned
Jan 7, 2011
Last updated
Apr 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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 4704253168 MI Primary

Addresses

Primary practice location

2450 Walton Blvd
Rochester Hills, MI 48309-1481

Mailing address

921 Sherwood Dr
Lake Bluff, IL 60044-2203
Phone (800) 444-6110

Other identifiers 2

IdentifierTypeStateIssuer
4704253168OtherMIMI LIC
RN9318095OtherFLFL LIC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170919004119 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103009709 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anupama Shah MD, PLC CurrentSince Aug 1, 2017 Accepting new patients
Birmingham Anesthesia Staffing Group LLC Nurse Anesthetist, Certified Registered CurrentSince May 17, 2024 Accepting new patients
Kumar Surgical Center LLC Anesthesiology CurrentSince May 1, 2022 Accepting new patients
Stephen J. Watts, MD, PLLC Past Accepting new patients

Locations

921 Sherwood Dr
Lake Bluff, IL 60044
Phone (847) 691-9080

1051 S Telegraph Rd
Ste 100
Monroe, MI 48161
Phone (734) 244-5383

1051 S Telegraph Rd
Ste 10
Monroe, MI 48161
Phone (734) 244-5383

2450 Walton Blvd
Rochester Hills, MI 48309
Phone (248) 650-0096

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1629372495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 SHERWOOD DR",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442203",
            "telephone_number": "800-444-6110",
            "fax_number": "772-581-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 WALTON BLVD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483091481",
            "telephone_number": "248-650-0096",
            "fax_number": "224-255-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "EVA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-07",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704253168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI LIC",
            "identifier": "4704253168",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LIC",
            "identifier": "RN9318095",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.