Individual provider Active NPI

Brian Bengtson

  • Certified Registered Nurse Anesthetist
  • Clinton Township, MI
National Provider Identifier
1881830487
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704235038 Issued in MI
Practice address
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone
(586) 263-2370
NPI assigned
Jan 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 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 4704235038 MI Primary

Addresses

Primary practice location

15855 19 Mile Rd
Clinton Township, MI 48038-3504

Mailing address

22101 Moross
Detroit, MI 48264
Phone (313) 343-4000

Other practice location 1

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090219000287 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092870410 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Macomb Hospital CorporationGroup PAC ID 7911808381, shared by 5 NPIs, 349 clinicians

Practice addresses (Care Compare)

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

Hospital & facility affiliations

  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704235038MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Jan 14, 2009 Accepting new patients
William Beaumont Hospital CurrentSince Mar 1, 2019 Accepting new patients
William Beaumont Hospital Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2019 Accepting new patients
Henry Ford Macomb Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2025 Accepting new patients
Henry Ford Macomb Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Sep 29, 2022 Accepting new patients
Henry Ford Health St. John Hospital Nurse Anesthetist, Certified Registered CurrentSince Jan 14, 2009 Accepting new patients
Henry Ford Macomb Hospital Corporation Current Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Sep 29, 2022 Accepting new patients
Waterford Anesthesia, PLLC CurrentSince Jul 1, 2015 Accepting new patients
Waterford Surgical Center, LLC Past Accepting new patients

Locations

7915 Solutions Ctr Dr
Chicago, IL 60677

30795 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 421-3000

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

1546 Callis Rd
Lapeer, MI 48446
Phone (810) 667-4000

3601 W 13 Mile Rd
Royal Oak, MI 48073

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

5220 Highland Rd
Ste 1
Waterford, MI 48327
Phone (248) 886-5555

5220 Highland Rd
Ste 100
Waterford, MI 48327
Phone (248) 461-2800

Interoperability endpoints

  • Direct secure messaging: bbengtson790231@direct.hfhs.org

Organizations & group practices 10

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 2

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": "1230854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1881830487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22101 MOROSS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48264",
            "telephone_number": "313-343-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22101 Moross Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48236",
            "country_code": "US",
            "telephone_number": "313-343-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENGTSON",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-02",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704235038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.