Individual provider Active NPI

Jaime T Bagnell-Leonardo, CRNA

  • Certified Registered Nurse Anesthetist
  • Ann Arbor, MI
National Provider Identifier
1689640526
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704209675 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Feb 28, 2006
Last updated
Mar 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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 4704209675 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 identifiers 2

IdentifierTypeStateIssuer
430F364420OtherMIBCBSM
4327205MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000140 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688646540 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center SaultGroup PAC ID 7315936481, 101 clinicians

Practice addresses (Care Compare)

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

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

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

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

500 Osborn Blvd
Sault S Marie, MI 49783-1822
Phone (906) 635-4460

7500 Challis Rd
Brighton, MI 48116-9416
Phone (734) 936-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Nurse Anesthetist, Certified Registered CurrentSince May 8, 2012 Accepting new patients
PSJ Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Apr 25, 2016 Accepting new patients
Northwestern Services, LLC CurrentSince Aug 18, 2020 Accepting new patients
West Michigan Aas LLC CurrentSince Jan 1, 2022 Accepting new patients
Novi Aas LLC CurrentSince Sep 1, 2020 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Mymichigan Medical Center Sault CurrentSince Mar 27, 2023 Accepting new patients
Michigan Crnas Staffing LLC CurrentSince Feb 5, 2017 Accepting new patients
Northwestern Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 18, 2020 Accepting new patients
Southfield Rehabilitation Company Nurse Anesthetist, Certified Registered Current Accepting new patients
Mymichigan Medical Center Sault CurrentSince Mar 27, 2023 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Oct 2, 2025 Accepting new patients
Regents of the University of Michigan CurrentSince May 8, 2012 Accepting new patients
Ambulatory Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2012 Accepting new patients
Kalamazoo Anesthesiology P C CurrentSince May 1, 2024 Accepting new patients
Southfield Rehabilitation Company CurrentSince Sep 21, 2012 Accepting new patients
Straith Hospital for Special Surgery Past Accepting new patients
Beaumont West Bloomfield ASC LLC Past Accepting new patients
Beaumont West Bloomfield ASC LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3621 S State St
#700
Ann Arbor, MI 48108

1500 E Medical Center Dr
#1H247
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

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

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

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

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

30055 Northwestern Hwy
Ste L-60
Farmington Hills, MI 48334
Phone (248) 265-6555

4024 Park East Ct SE
Grand Rapids, MI 49546
Phone (231) 592-3102

900 Peeler St
Kalamazoo, MI 49008
Phone (269) 345-8618

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

25500 Meadowbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 477-0220

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

22401 Foster Winter Dr
Southfield, MI 48075
Phone (248) 423-4100

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

230 W Maple Rd
Troy, MI 48084
Phone (248) 244-1500

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 4

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1689640526",
    "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": [],
    "basic": {
        "last_name": "BAGNELL-LEONARDO",
        "first_name": "JAIME",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704209675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "430F364420",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4327205",
            "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 Mar 10, 2020; 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.