Individual provider Active NPI

Joseph Shovan, CRNA

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1801345566
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704295628 Issued in MI
Practice address
22101 Moross Rd
Detroit, MI 48236
Phone
(313) 343-4000
NPI assigned
Sep 22, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 4704295628 MI
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 4704295628 MI Primary

Addresses

Primary practice location

22101 Moross Rd
Detroit, MI 48236

Mailing address

200 Virginia Ave Apt 8
Royal Oak, MI 48067-1848

Other practice location 1

3219 N Blair Ave
Royal Oak, MI 48073-3561
Phone (586) 854-7912

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180130002364 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395005920 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester Medical Associates PLLCGroup PAC ID 8729318704, 23 clinicians
Henry Ford Macomb Hospital CorporationGroup PAC ID 7911808381, shared by 5 NPIs, 349 clinicians

Practice addresses (Care Compare)

1349 S Rochester Rd
Suite 150
Rochester Hills, MI 48307-3152
Phone (248) 844-3800

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704295628MIMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Single Specialty CurrentSince Dec 28, 2017 Accepting new patients
Henry Ford Macomb Hospital Corporation Single Specialty CurrentSince Sep 29, 2022 Accepting new patients
Rochester Medical Associates, PLLC Single Specialty CurrentSince Jan 1, 2026 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Dec 28, 2017 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Sep 29, 2022 Accepting new patients
Henry Ford Macomb Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2025 Accepting new patients
Henry Ford Macomb Hospital Corporation Single Specialty Current Accepting new patients

Locations

7915 Solutions Ctr Dr
Chicago, IL 60677

30795 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 421-3000

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

1349 S Rochester Rd
Ste 150
Rochester Hills, MI 48307
Phone (248) 844-3800

Interoperability endpoints

  • Direct secure messaging: jshovan430993@direct.hfhs.org

Organizations & group practices 7

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 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": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1801345566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VIRGINIA AVE APT 8",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48236",
            "telephone_number": "313-343-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3219 N Blair Ave",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480733561",
            "country_code": "US",
            "telephone_number": "586-854-7912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOVAN",
        "first_name": "JOSEPH",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-22",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "MI",
            "license": "4704295628",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704295628",
            "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 Jul 30, 2018; 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.