Individual provider Active NPI

Eliah B Spasevski, CRNA

  • Certified Registered Nurse Anesthetist
  • Merrillville, IN
National Provider Identifier
1962414896
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28134611A Issued in IN
Practice address
8701 Broadway # C-124
Merrillville, IN 46410-7035
Phone
(219) 738-4929
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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 28134611A IN Primary

Addresses

Primary practice location

8701 Broadway # C-124
Merrillville, IN 46410-7035

Mailing address

PO Box 1123
Jackson, MI 49204-1123
Phone (517) 787-6440

Other names 1

  • Ilija Spasevski Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071101000341 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850488255 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Anesthesia PCGroup PAC ID 1951322353, 28 clinicians

Practice addresses (Care Compare)

1500 S Lake Park Ave
Hobart, IN 46342-6638
Phone (219) 942-0551

Hospital & facility affiliations

  • St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28134611AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ams Northern Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 19, 2022 Accepting new patients
Stat Anesthesia Specialists, LTD. CurrentSince Jan 25, 2020 Accepting new patients
Northstar Anesthesia of Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 26, 2022 Accepting new patients
Stat Anesthesia Specialists LTD Current Accepting new patients
Lakeshore Anesthesia, P.C. Nurse Anesthetist, Certified Registered CurrentSince Sep 26, 2007 Accepting new patients
Jebs Anesthesia Consultants, LLC CurrentSince Jul 29, 2023 Accepting new patients
Great Lakes Anesthesia, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jul 2, 2024 Accepting new patients
Methodist Anesthesia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc Past Accepting new patients

Locations

9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

1004 Parkway Ave
Ste A
Elkhart, IN 46516
Phone (800) 966-7841

7747 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-9104

5454 Hohman Ave
Hammond, IN 46320
Phone (219) 933-2077

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

8900 Broadway
Ste 100W
Merrillville, IN 46410
Phone (219) 576-6260

3212 Hickory Rd
Ste A
Mishawaka, IN 46545
Phone (574) 251-0498

9200 Calumet Ave
Ste S100
Munster, IN 46321
Phone (219) 576-6260

1915 Lake Ave
Plymouth, IN 46563
Phone (219) 936-3181

10220 Wicker Ave
Ste 3
Saint John, IN 46373
Phone (219) 515-6943

Organizations & group practices 9

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1962414896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1123",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492041123",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 BROADWAY # C-124",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107035",
            "telephone_number": "219-738-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPASEVSKI",
        "first_name": "ELIAH",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28134611A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILIJA",
            "last_name": "SPASEVSKI",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.