Individual provider Active NPI

Raymond Michael Lievens

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1770213852
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704309498 Issued in MI
Practice address
6071 W Outer Dr
Detroit, MI 48235-2624
Phone
(313) 966-3300
NPI assigned
Jun 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704309498 MI
Certified Registered Nurse Anesthetist 367500000X 4704309498 MI Primary

Addresses

Primary practice location

6071 W Outer Dr
Detroit, MI 48235-2624

Mailing address

1903 S Bates St
Birmingham, MI 48009-1977
Phone (586) 770-9231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220926002606 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981080124 Reassigns benefits to 1 organization
I20240410000657 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981080124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Michigan PLLCGroup PAC ID 9638481591, 192 clinicians
Southwest Ohio Anesthesia Consultants LLCGroup PAC ID 6901700640, 362 clinicians

Practice addresses (Care Compare)

3990 John R St
Detroit, MI 48201-2018
Phone (313) 993-0822

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3615

7500 State Rd
Cincinnati, OH 45255-2439
Phone (513) 624-4500

Hospital & facility affiliations

  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024
  • Harper University Hospital Hospital, Detroit, MI, CCN 230104
  • Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297
  • Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2022 Accepting new patients
Anesthesia & Intensive Care Consultants,Inc. Nurse Anesthetist, Certified Registered CurrentSince Mar 21, 2024 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 21, 2024 Accepting new patients

Locations

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1770213852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 S BATES ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480091977",
            "telephone_number": "586-770-9231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEVENS",
        "first_name": "RAYMOND",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704309498",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704309498",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 6, 2023; 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.