Active NPI
Stanley M. Michelcavage, CRNA
- Certified Registered Nurse Anesthetist
- Port Huron, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704151696
- Practice address
- 2601 Electric Ave
Port Huron, MI 48060-6587 - Phone
- (810) 985-1500
- Fax
- (810) 966-3104
- NPI assigned
- Sep 26, 2006
- Last updated
- Jul 8, 2007
- 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 | 4704151696 | MI | Primary |
Addresses
Primary practice location
2601 Electric Ave
Port Huron, MI 48060-6587
Mailing address
2614 Farmdale Dr
Sterling Heights, MI 48314-3868
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 425219610 | Medicaid | MI | |
| SM151696 | Other | MI | BLUE CROSS |
| P100918 | Other | MI | BCN |
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, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 585-3023
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 67.5 of 100
- Quality
- 58.12
- Improvement activities
- 40
- Cost
- 68.45
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health Macomb-Oakland Hospital | Current | Accepting new patients | |
| Anesthesia Associates of Ann Arbor, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Henry Ford Health Macomb-Oakland Hospital | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Waterford Surgical Center, LLC | Past | Accepting new patients | |
| St. Joseph Mercy Hospital Crna Group | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
7924 Solutions Ctr Dr
Chicago, IL 60677
2006 Hogback Rd
Ste 5
Ann Arbor, MI 48105
Phone (313) 712-4331
620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450
27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000
44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000
1560 E Maple Rd
Troy, MI 48083
Phone (248) 581-5729
1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001
Organizations & group practices 5
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.
-
- Anesthesiology Physician
- Westland, MI
- NPI 1669581997
Nurse Anesthetist, Certified Registered
-
dba St. John Oakland Hospital CRNAs
- Certified Registered Nurse Anesthetist
- Madison Heights, MI
- NPI 1871793505
Nurse Anesthetist, Certified Registered
-
dba Henry Ford Warren Hospital
- Social Worker
- Warren, MI
- NPI 1548609761
-
- Certified Registered Nurse Anesthetist
- Pontiac, MI
- NPI 1568493047
Nurse Anesthetist, Certified Registered
-
- Ambulatory Surgical Clinic/Center
- Waterford, MI
- NPI 1467788729
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Joseph Mercy Oakland
- General Acute Care Hospital
- Pontiac, MI
- NPI 1053356352
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750482568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2614 FARMDALE DR",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483143868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 ELECTRIC AVE",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480606587",
"telephone_number": "810-985-1500",
"fax_number": "810-966-3104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHELCAVAGE",
"first_name": "STANLEY",
"middle_name": "M.",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704151696",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "425219610",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "SM151696",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCN",
"identifier": "P100918",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port Huron, 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.