Tara Crisanti, BSN, RN, SRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Detroit, MI
NPI 1821789975 · NPPES record last updated Aug 23, 2023
Key facts
- NPI
- 1821789975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 4704322680 (MI)
- Practice address
- 259 Mack Ave
Detroit, MI 48201-2427 - Phone
- (248) 880-8477
- NPI assigned
- May 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 14
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Northstar Anesthesia of Michigan III PLLC
Practice addresses (Care Compare)
33155 Annapolis St
Wayne, MI 48184-2405
Phone (214) 687-0001
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (214) 687-0001
Hospital & facility affiliations
- Beaumont Hospital Royal Oak
- Scheurer Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230921003549 | MI | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 7113371352 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scheurer Hospital | Single Specialty | Current |
Accepting new patients |
| Scheurer Hospital | Current | Accepting new patients | |
| Scheurer Hospital | Single Specialty | Current |
Accepting new patients |
| Northstar Anesthesia of Michigan III PLLC | Single Specialty | Current |
Accepting new patients |
| Scheurer Hospital | Current |
Accepting new patients |
Locations
170 N Caseville Rd
Pigeon, MI 48755
Phone (989) 453-3223
33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704322680 | MI | |
| Certified Registered Nurse Anesthetist |
367500000X | 4704322680 | MI | Yes |
Addresses
Primary practice location
259 Mack Ave
Detroit, MI 48201-2427
Mailing address
259 Mack Ave
Detroit, MI 48201-2427
Other providers in Detroit, MI
- Rohn Marie Crichlow
- Abby E Crider
- Belinda Lorraine Crider
- Wolfgang V. Crider
- Heather Evelyn Crimmins
- Sara Marie Crisenbery
- Crisp Care Consulting LLC
- Lashonda Nicole Crisp
- John D Crissman
- Gianina Cristiu
All providers in Detroit, 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 Aug 23, 2023. 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.