Individual provider Active NPI

Edward Arthur Fleck, CRNA

  • Certified Registered Nurse Anesthetist
  • Dearborn, MI
National Provider Identifier
1750425047
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704234251 Issued in MI
Practice address
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone
(313) 436-2374
NPI assigned
Feb 19, 2007
Last updated
Jul 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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 4704234251 MI Primary

Addresses

Primary practice location

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Mailing address

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 436-2374

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070508000040 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365548385 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (214) 687-0001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704234251MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2020 Accepting new patients
St. Joseph Mercy Hospital Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

10000 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-5000

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4000

Organizations & group practices 3

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1750425047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-436-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-436-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLECK",
        "first_name": "EDWARD",
        "middle_name": "ARTHUR",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704234251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.