Individual provider Active NPI

Elaine P Wynter, CRNA

  • Certified Registered Nurse Anesthetist
  • Warren, MI
National Provider Identifier
1740345628
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704148069 Issued in MI
Practice address
11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone
(586) 573-5260
Fax
(586) 573-5364
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4704148069 MI Primary

Addresses

Primary practice location

11800 E 12 Mile Rd
Warren, MI 48093-3472

Mailing address

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (586) 573-5260

Other identifiers 2

IdentifierTypeStateIssuer
4814779MedicaidMI
4852377MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105001117 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769474824 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Ann Arbor PLLCGroup PAC ID 1355317223, 213 clinicians
Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Practice addresses (Care Compare)

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 585-3023

826 W King St
Memorial Medical Associates
Owosso, MI 48867-2120
Phone (989) 723-5211

Hospital & facility affiliations

  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
  • Memorial Healthcare Hospital, Owosso, MI, CCN 230121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704148069MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Sep 14, 2020 Accepting new patients
Henry Ford West Bloomfield Hospital CurrentSince Mar 15, 2009 Accepting new patients
Alliance Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 18, 2019 Accepting new patients
Anesthesia Associates of Ann Arbor, PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2018 Accepting new patients
Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Sep 14, 2020 Accepting new patients
Henry Ford West Bloomfield Hospital Nurse Anesthetist, Certified Registered CurrentSince Mar 15, 2009 Accepting new patients
Beaumont West Bloomfield ASC LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Sunrise Anesthesiology of Michigan, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Beaumont Macomb Township ASC, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
St. Joseph Mercy Hospital Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients
Ambulatory Anesthesia Associates, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Eastside Group LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Henry Ford Health Providence Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Waterford Surgical Center, LLC Past Accepting new patients

Locations

2006 Hogback Rd
Ste 5
Ann Arbor, MI 48105
Phone (313) 712-4331

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

4800 S Saginaw St
Ste 1845
Flint, MI 48507
Phone (810) 275-9152

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

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

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

1560 E Maple Rd
Troy, MI 48083
Phone (248) 581-5729

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Organizations & group practices 14

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.

View all 14

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": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740345628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5260",
            "fax_number": "586-573-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5260",
            "fax_number": "586-573-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNTER",
        "first_name": "ELAINE",
        "middle_name": "P",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704148069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4814779",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4852377",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.