Individual provider Active NPI

Amanda Marie Jablonski, CRNA

  • Certified Registered Nurse Anesthetist
  • Ann Arbor, MI
National Provider Identifier
1720444342
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704266155 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Jan 12, 2016
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704266155 MI Primary
Registered Nurse 163W00000X 4704266155 MI

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ajablonski48794@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160322002769 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799082525 Reassigns benefits to 3 organizations
I20161114001531 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799082525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 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

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

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

7500 State Rd
Cincinnati, OH 45255-2439
Phone (513) 624-4500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704266155MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Jun 17, 2022 Accepting new patients
Anesthesia & Intensive Care Consultants,Inc. Nurse Anesthetist, Certified Registered CurrentSince Apr 28, 2025 Accepting new patients
Mercy Memorial Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2016 Accepting new patients
Mercy Memorial Hospital Corporation CurrentSince Oct 1, 2016 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Feb 3, 2016 Accepting new patients
Regents of the University of Michigan Nurse Anesthetist, Certified Registered CurrentSince Oct 25, 2016 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 28, 2025 Accepting new patients
Promedica Central Physicians CurrentSince Jun 17, 2022 Accepting new patients
Regents of the University of Michigan CurrentSince Oct 25, 2016 Accepting new patients

Locations

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

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

3621 S State St
#700
Ann Arbor, MI 48108

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

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

2801 Bay Park Dr
Oregon, OH 43616
Phone (419) 690-7652

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

5200 Harroun Rd
Sylvania, OH 43560
Phone (419) 824-1305

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2901 N Reynolds Rd
Toledo, OH 43615
Phone (419) 578-7107

3404 W Sylvania Ave
Toledo, OH 43623
Phone (419) 407-1422

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, 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": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1720444342",
    "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": "JABLONSKI",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2023-11-03",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704266155",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704266155",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajablonski48794@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 3, 2023; 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.