Individual provider Active NPI

Brian Eells, CRNA

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1962495630
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704213639 Issued in MI
Practice address
3901 Beaubien St
Detroit, MI 48201-2119
Phone
(952) 442-9770
NPI assigned
Aug 26, 2005
Last updated
Aug 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

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 4704213639 MI Primary

Addresses

Primary practice location

3901 Beaubien St
Detroit, MI 48201-2119

Mailing address

PO Box 67000
Dept 203401
Detroit, MI 48267-0002
Phone (952) 442-9770

Other identifiers 3

IdentifierTypeStateIssuer
527892243OtherMITRICARE
BE213639OtherMIBLUE CROSS
104300972MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090402000177 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355498668 Reassigns benefits to 7 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704213639MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients
Vision Institute of Michigan Surgery Center PC CurrentSince Apr 1, 2024 Accepting new patients
Novi Aas LLC CurrentSince Mar 1, 2016 Accepting new patients
Michigan Crnas Staffing LLC CurrentSince Feb 3, 2016 Accepting new patients
Northstar Anesthesia of Michigan PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 10, 2016 Accepting new patients
Essential Anesthesia Services, PLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2013 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 29, 2021 Accepting new patients

Locations

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

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

25500 Meadowbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 477-0220

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

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

44650 Delco Blvd
Ste 200
Sterling Hts, MI 48313
Phone (586) 254-3391

264 W Maple Rd
Ste 100
Troy, MI 48084
Phone (248) 269-5594

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219622400000",
    "number": "1962495630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000",
            "address_2": "DEPT 203401",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670002",
            "telephone_number": "952-442-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "952-442-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EELLS",
        "first_name": "BRIAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704213639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "527892243",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "BE213639",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104300972",
            "state": "MI"
        }
    ],
    "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 Aug 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.