NPIMap

Individual provider Active NPI

Alyssa Knaack

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1912484908
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704299654 Issued in MI
Practice address
22101 Moross Rd
Detroit, MI 48236-2148
Phone
(248) 321-8967
NPI assigned
Jul 23, 2018
Last updated
Jun 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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 4704299654 MI Primary
Registered Nurse 163W00000X 4704299654 MI

Addresses

Primary practice location

22101 Moross Rd
Detroit, MI 48236-2148

Mailing address

42489 Willsharon St
Sterling Heights, MI 48314-3077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181101001117 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466705843 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Wayne State University School of Medicine, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Asa Staffing IncGroup PAC ID 3971898644, 146 clinicians
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

33155 Annapolis St
Wayne, MI 48184-2405
Phone (214) 687-0001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Oct 1, 2018 Accepting new patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2023 Accepting new patients
Henry Ford Health Providence Hospital CurrentSince Mar 23, 2025 Accepting new patients
PSJ Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2024 Accepting new patients
Southfield Rehabilitation Company CurrentSince Apr 1, 2019 Accepting new patients
Eastern District Anesthesiology PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2021 Accepting new patients
Henry Ford Health St. John Hospital Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2018 Accepting new patients
Southfield Rehabilitation Company Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2019 Accepting new patients
Henry Ford Health Providence Hospital Nurse Anesthetist, Certified Registered CurrentSince Mar 23, 2025 Accepting new patients

Locations

7915 Solutions Ctr Dr
Chicago, IL 60677

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

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

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

1349 S Rochester Rd
Ste 250
Rochester Hills, MI 48307
Phone (248) 601-0040

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

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

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, 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": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1912484908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42489 WILLSHARON ST",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "248-321-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAACK",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704299654",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704299654",
            "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 Jun 12, 2020; 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.