Active NPI
Anthony J Dicicco, CRNA
- Certified Registered Nurse Anesthetist
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704286959
- Practice address
- 1500 E Medical Center Dr
Ann Arbor, MI 48109-5000 - Phone
- (734) 936-4000
- NPI assigned
- Jan 11, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704286959 | 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000
33155 Annapolis St
Wayne, MI 48184-2405
Phone (214) 687-0001
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704286959 | MI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of Michigan | Current | Accepting new patients | |
| Asa Staffing Inc | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| William Beaumont Hospital | Current | Accepting new patients | |
| William Beaumont Hospital | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Rochester Medical Associates, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Superior Anesthetists Associates, Inc. | Current | Accepting new patients | |
| Northstar Anesthesia of Michigan III PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229
1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000
50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300
1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300
1349 S Rochester Rd
Ste 150
Rochester Hills, MI 48307
Phone (248) 844-3800
3601 W 13 Mile Rd
Royal Oak, MI 48073
29110 Inkster Rd
Ste 100
Southfield, MI 48034
Phone (248) 234-9300
4550 Investment Dr
Troy, MI 48098
Phone (248) 265-4600
130 Town Center Dr
Ste 203
Troy, MI 48084
Phone (248) 585-8250
44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255
33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042
Organizations & group practices 7
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.
-
- Certified Registered Nurse Anesthetist
- Rochester, MI
- NPI 1114378981
Nurse Anesthetist, Certified Registered
-
- Pain Medicine (Anesthesiology) Physician
- Irving, TX
- NPI 1972126209
MI, Nurse Anesthetist, Certified Registered
-
- Internal Medicine Physician
- Ann Arbor, MI
- NPI 1205868353
-
- Anesthesiology Physician
- Rochester Hills, MI
- NPI 1396398681
Nurse Anesthetist, Certified Registered
-
- Specialist
- Troy, MI
- NPI 1831144518
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1811044878
Nurse Anesthetist, Certified Registered
-
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Shelby Township, MI
- NPI 1184206385
-
- General Acute Care Hospital
- Mount Clemens, MI
- NPI 1316938327
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1740726033",
"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": "DICICCO",
"first_name": "ANTHONY",
"middle_name": "J",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-11",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704286959",
"primary": true
}
],
"identifiers": [],
"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 Nov 16, 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.