Active NPI
Ryan Korodan
- Certified Registered Nurse Anesthetist
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704285840
- Practice address
- 2799 W Grand Blvd FL 3
Detroit, MI 48202-2608 - Phone
- (313) 916-8078
- NPI assigned
- Jul 11, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704285840 | MI | Primary |
| Registered Nurse | 163W00000X | 4704285840 | MI |
Addresses
Primary practice location
2799 W Grand Blvd FL 3
Detroit, MI 48202-2608
Mailing address
1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (800) 436-7936
Other practice location 1
16981 Kensington Dr
Macomb, MI 48044-4093
Phone (586) 604-1952
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
- Group practices
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Michigan III PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Henry Ford Health System | Past | Accepting new patients |
Locations
33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042
Organizations & group practices 2
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.
-
- Pain Medicine (Anesthesiology) Physician
- Irving, TX
- NPI 1972126209
MI, Nurse Anesthetist, Certified Registered
-
- Internal Medicine Physician
- Detroit, MI
- NPI 1891702833
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Beaumont Hospital, Troy
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
dba Beaumont Hospital, Royal Oak
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
-
dba Beaumont Hospital, Grosse Pointe
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1861064842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FORD PL STE 3A",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023450",
"telephone_number": "800-436-7936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD FL 3",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "313-916-8078"
}
],
"practiceLocations": [
{
"address_1": "16981 Kensington Dr",
"address_purpose": "LOCATION",
"city": "Macomb",
"state": "MI",
"postal_code": "480444093",
"country_code": "US",
"telephone_number": "586-604-1952",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KORODAN",
"first_name": "RYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-11",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704285840",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704285840",
"primary": false
}
],
"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 13, 2026; 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.