Shannon Boldenow

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704283091 Issued in MI

Practice address

44405 Woodward Ave
Pontiac, MI 48341-5023

Phone

(248) 858-3000

NPI assigned

Jan 12, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Merit-based Incentive Payment System (MIPS)

Final score

67.5 of 100Reported as group

Quality

58.12

Improvement activities

40

Cost

68.45

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Northstar Anesthesia of Michigan III PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Irving, TX
  • NPI 1972126209

  MI, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Axon Anesthesia Consultants, PLC

  • Anesthesiology Physician
  • Lake Orion, MI
  • NPI 1235643495
  Medicare reassignment NPD
• Michigan Crnas Staffing LLC

  • Anesthesiology Physician
  • Novi, MI
  • NPI 1851666424
  Medicare reassignment NPD
• Northwestern Services, LLC

  • Certified Registered Nurse Anesthetist
  • Farmington Hills, MI
  • NPI 1215106679

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Nsa Pain Services of Michigan III, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Taylor, MI
  • NPI 1376169524
  Medicare reassignment NPD
• Northwestern Services, LLC

  • Anesthesiology Physician
  • Farmington Hills, MI
  • NPI 1083883649
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation

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

{
    "created_epoch": "1578787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578787200000",
    "number": "1720628357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 ALTON CT",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480855044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDENOW",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-12",
        "last_updated": "2020-01-12",
        "certification_date": "2020-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704283091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin Bohr
• Barbara Boillat, MA LLPC
• Abigail Renee Boisvert
• Braden Matthew Boji, MD
• Abdullah Bokhari, D.O.
• Ricky Boldman
• Steven Bolton, M.D.
• Natasha Booker
• Sumaya Boomgaard, P.T.
• Melinda Claris Boone, NURSE

• Certified Registered Nurse Anesthetist in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.