Individual provider Active NPI

Nicole A Dimuzio, CRNA

  • Certified Registered Nurse Anesthetist
  • Southfield, MI
National Provider Identifier
1841386547
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704216688 Issued in MI
Practice address
22401 Foster Winter Dr
Southfield, MI 48075-3724
Phone
(248) 423-5198
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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 4704216688 MI Primary

Addresses

Primary practice location

22401 Foster Winter Dr
Southfield, MI 48075-3724

Mailing address

1000 Harrington Blvd
Mount Clemens, MI 48043
Phone (586) 493-8747

Other practice location 1

1000 Harrington Blvd
Mount Clemens, MI 48043
Phone (586) 493-8747

Other practice location 2

11012 E 13 Mile Rd Ste 112A
Warren, MI 48093-2546
Phone (586) 751-9800

Other identifiers 2

IdentifierTypeStateIssuer
4580796MedicaidMI
4601519MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040323001866 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052202470 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians
Anesthesia Associates of Ann Arbor PLLCGroup PAC ID 1355317223, 213 clinicians
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

159 Kercheval Ave
Grosse Pointe Farms, MI 48236-3610
Phone (313) 640-1000

2006 Hogback Rd
Ann Arbor, MI 48105-9750

2799 W Grand Blvd
Detroit, MI 48202-2608

2799 W Grand Boulevard
Detroit, MI 48202-2608
Phone (313) 916-2600

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (214) 687-0001

Hospital & facility affiliations

  • Surgeons Choice Medical Center Hospital, Southfield, MI, CCN 230301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704216688MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Gastrointestinal Health at Health Park LLC CurrentSince Apr 1, 2024 Accepting new patients
Henry Ford Health System CurrentSince May 21, 2012 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince May 5, 2022 Accepting new patients
GLPS Staffing Solutions LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2014 Accepting new patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince May 21, 2012 Accepting new patients
Anesthesia Associates of Ann Arbor, PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2025 Accepting new patients

Locations

2006 Hogback Rd
Ste 5
Ann Arbor, MI 48105
Phone (313) 712-4331

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

600 Health Park Blvd
Ste E
Grand Blanc, MI 48439
Phone (810) 503-8210

159 Kercheval Ave
Grosse Pointe Farms, MI 48236
Phone (313) 640-1000

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

3601 W 13 Mile Rd
Royal Oak, MI 48073

22401 Foster Winter Dr
Southfield, MI 48075
Phone (248) 423-4100

11012 E 13 Mile Rd
Ste 112A
Warren, MI 48093
Phone (586) 573-6880

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Interoperability endpoints

  • Direct secure messaging: ndimuzio867807@direct.hfhs.org

Organizations & group practices 6

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1841386547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON BLVD",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "586-493-8747",
            "fax_number": "586-493-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22401 FOSTER WINTER DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753724",
            "telephone_number": "248-423-5198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Harrington Blvd",
            "address_purpose": "LOCATION",
            "city": "Mount Clemens",
            "state": "MI",
            "postal_code": "48043",
            "country_code": "US",
            "telephone_number": "586-493-8747",
            "fax_number": "586-493-8741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11012 E 13 Mile Rd Ste 112A",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480932546",
            "country_code": "US",
            "telephone_number": "586-751-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIMUZIO",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704216688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4580796",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4601519",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.