Individual provider Active NPI

Michael Lee Loudner, CRNA

  • Certified Registered Nurse Anesthetist
  • Syracuse, NY
National Provider Identifier
1861822116
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
535456 Issued in NY
Practice address
750 E Adams St RM 4143
Syracuse, NY 13210-1834
Phone
(315) 469-4891
Fax
(315) 464-4905
NPI assigned
Nov 24, 2013
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 535456 NY Primary
Registered Nurse 163W00000X 535456 NY

Addresses

Primary practice location

750 E Adams St RM 4143
Syracuse, NY 13210-1834

Mailing address

5784 Widewaters Pkwy
Floor 2
Syracuse, NY 13214-1890
Phone (315) 469-1130

Other practice location 1

4842 broad rd
Syracuse, NY 13205
Phone (315) 492-5011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140310000317 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042440224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
State University of New York at Buffalo School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Medical Anesthesiology Group IncGroup PAC ID 8921992389, 76 clinicians

Practice addresses (Care Compare)

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-4720

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.42 of 100Reported as group
Quality
97.55
Promoting interoperability
100
Improvement activities
40
Cost
82.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
535456NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Chag Anesthesia PC CurrentSince May 23, 2017 Accepting new patients
Upstate Medical Anesthesiology Group, Inc. CurrentSince Feb 1, 2014 Accepting new patients
Syracuse Endoscopy Associates, LLC PastSince Jul 21, 2024 Accepting new patients

Locations

163 Intrepid Ln
#100
Syracuse, NY 13205

190 Intrepid Ln
Syracuse, NY 13205
Phone (315) 498-6200

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

5784 Widewaters Pkwy
Ste 2
Syracuse, NY 13214
Phone (315) 469-1134

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

750 E Adams St
Rm 4143
Syracuse, NY 13210
Phone (315) 464-4720

Interoperability endpoints

  • Direct secure messaging: mloudner24344@direct.upstate.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1385251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1861822116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5784 WIDEWATERS PKWY",
            "address_2": "FLOOR 2",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141890",
            "telephone_number": "315-469-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST RM 4143",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101834",
            "telephone_number": "315-469-4891",
            "fax_number": "315-464-4905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4842 broad rd",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "13205",
            "country_code": "US",
            "telephone_number": "315-492-5011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUDNER",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-24",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "535456",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "535456",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.