Individual provider Active NPI

Lori A Bazey, CRNA

  • Certified Registered Nurse Anesthetist
  • Grand Forks, ND
National Provider Identifier
1780790394
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R22456 Issued in ND
Practice address
3035 Demers Ave
Grand Forks, ND 58201-4040
Phone
(701) 775-3151
NPI assigned
Aug 23, 2006
Last updated
Apr 23, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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 R22456 ND Primary

Addresses

Primary practice location

3035 Demers Ave
Grand Forks, ND 58201-4040

Mailing address

3366 Desert Star LN
Grand Forks, ND 58201-5823
Phone (701) 746-7441

Other identifiers 5

IdentifierTypeStateIssuer
430010862OtherRR MEDICARE
010M8BAOtherMNBCBS
11931MedicaidND
021269OtherNDBCBS
661345400MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091026000250 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305835760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Forks Anesthesia AssociatesGroup PAC ID 6002151479, 2 clinicians

Practice addresses (Care Compare)

2600 47TH Ave S
Grand Forks, ND 58201-3642
Phone (701) 738-4248

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R22456NDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Forks Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Oct 31, 2018 Accepting new patients
Aurora Surgery Center, LLC Past Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

2600 47th Ave S
Grand Forks, ND 58201
Phone (701) 738-4240

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1780790394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 DESERT STAR LN",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015823",
            "telephone_number": "701-746-7441",
            "fax_number": "701-746-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014040",
            "telephone_number": "701-775-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZEY",
        "first_name": "LORI",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R22456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "430010862",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010M8BA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11931",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "021269",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "661345400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.