Jerry Robert Jurecic, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Marquette, MI
NPI 1821335902 · NPPES record last updated Jan 10, 2013
Key facts
- NPI
- 1821335902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 4704269918 (MI)
- Practice address
- 580 W College Ave
Marquette, MI 49855-2736 - Phone
- (906) 225-3035
- Fax
- (906) 225-3697
- NPI assigned
- Jan 10, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- South Shore Anesthesia Staffing
Practice addresses (Care Compare)
1414 W Fair Ave
Marquette, MI 49855-5406
Phone (906) 361-4901
Hospital & facility affiliations
- Munising Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130618000290 | MI | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 8224277520 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704269918 | MI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acquisition Bell Hospital LLC | Current |
Accepting new patients | |
| Acquisition Bell Hospital LLC | Current |
Accepting new patients | |
| South Shore Anesthesia Staffing | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Baraga County Memorial Hospital | Current | Accepting new patients |
Locations
901 Lakeshore Dr
Ishpeming, MI 49849
Phone (906) 485-2653
1414 W Fair Ave
Ste 235
Marquette, MI 49855
Phone 9062732223103
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704269918 | MI | Yes |
Addresses
Primary practice location
580 W College Ave
Marquette, MI 49855-2736
Mailing address
755 S Vandenboom Rd
Marquette, MI 49855-9455
Phone (906) 362-3312
Other providers in Marquette, MI
- Jasmine Joseph
- Kaitlyn Marie Joyce
- Joyful Raine Therapy and Holistic Care LLC
- Gabrielle Juidici
- Anthony Joseph Jurecic
- K.T. P.T., LLC
- Laura Kagy
- Dorothy S Kahler
- Kyle Kakuk
- Jaime Kangas
All providers in Marquette, MI · Certified Registered Nurse Anesthetist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.