NPIMap

Individual provider Active NPI

John McKay Perkowski, CRNA

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1760477871
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704130120 Issued in MI
Practice address
4201 Saint Antoine St
Detroit, MI 48201-2153
Phone
(952) 442-9770
Fax
(952) 442-3630
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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 4704130120 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St
Detroit, MI 48201-2153

Mailing address

PO Box 67000
Dept 203401
Detroit, MI 48267-0002
Phone (952) 442-9770

Other identifiers 2

IdentifierTypeStateIssuer
104300490MedicaidMI
JP130120OtherMIBLUE CROSS OF MI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan Past Accepting new patients
Saint Joseph Mercy Livingston Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Henry Ford Health Providence Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Garden City Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://phsfhir.primehealthcare.com/PHS-PRD-FHIR/api/FHIR/R4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1760477871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000",
            "address_2": "DEPT 203401",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670002",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKOWSKI",
        "first_name": "JOHN",
        "middle_name": "MCKAY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704130120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104300490",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MI",
            "identifier": "JP130120",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.