Tara Lee Maclaren-Gibson, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Pontiac, MI
NPI 1720171861 · NPPES record last updated Jun 24, 2010
Key facts
- NPI
- 1720171861
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 47054231671 (MI)
- Practice address
- 44405 Woodward Ave
Pontiac, MI 48341-5023 - Phone
- (248) 858-6593
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West Michigan Aas LLC
Northwestern Services LLC
Eastside Group LLC
Practice addresses (Care Compare)
25500 Meadowbrook Rd
Suite 110
Novi, MI 48375-1879
Phone (248) 477-2200
30055 Northwestern Hwy
Suite L 60
Farmington Hills, MI 48334-3274
Phone (248) 265-6555
36750 26 Mile Rd
Suite 210
Chesterfield, MI 48047-2926
Phone (586) 473-6400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060406000053 | MI | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 8224047030 | Reassigns benefits to 8 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47054231671 | MI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Michigan Aas LLC | Current |
Accepting new patients | |
| Michigan Crnas Staffing LLC | Current |
Accepting new patients | |
| Superior Anesthetists Associates, Inc. | Current |
Accepting new patients | |
| Rochester Medical Associates, PLLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Eastside Group LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Waterford Anesthesia, PLLC | Current |
Accepting new patients | |
| Novi Aas LLC | Current |
Accepting new patients | |
| Northwestern Services, LLC | Current |
Accepting new patients | |
| Northwestern Services, LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Waterford Surgical Center, LLC | Past | Accepting new patients | |
| St. Joseph Mercy Hospital Crna Group | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Eastside Associates, LLC | Past |
Accepting new patients | |
| Bloomfield Anesthesia, PC | Past | Accepting new patients | |
| Beaumont Macomb Township ASC, LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
36750 26 Mile Rd
Ste 210
Chesterfield, MI 48047
Phone (586) 473-6400
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
3800 Centennial Dr
Grass Lake, MI 49240
Phone (517) 701-3100
1546 Callis Rd
Lapeer, MI 48446
Phone (810) 667-4000
43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658
25500 Meadowbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 477-0220
1349 S Rochester Rd
Ste 210
Rochester Hills, MI 48307
Phone (248) 844-2600
1349 S Rochester Rd
Ste 150
Rochester Hills, MI 48307
Phone (248) 844-3800
28963 Little Mack Ave
Ste 10
St Clr Shores, MI 48081
Phone (586) 447-5110
1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001
130 Town Center Dr
Ste 130
Troy, MI 48084
Phone (248) 624-7246
4550 Investment Dr
Ste 100
Troy, MI 48098
Phone (248) 265-4600
4550 Investment Dr
Troy, MI 48098
Phone (248) 265-4600
5220 Highland Rd
Ste 100
Waterford, MI 48327
Phone (248) 461-2800
5220 Highland Rd
Ste 1
Waterford, MI 48327
Phone (248) 886-5555
Interoperability endpoints
- gtara1071780@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 47054231671 | MI | Yes |
Addresses
Primary practice location
44405 Woodward Ave
Pontiac, MI 48341-5023
Mailing address
255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440
Other providers in Pontiac, MI
- Lynn Optical Associates PC
- David Lynn
- M a Verardi MD PC
- Michael Mack
- Soundra D Mackavich
- Lauren Macleod
- Jennifer Macquarrie
- Alexander Samuel Madgy
- Julayne Valrie Magee
- Michael Maiden
All providers in Pontiac, MI · Certified Registered Nurse Anesthetist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.