Individual provider Active NPI

Michael Hanlon

  • Certified Registered Nurse Anesthetist
  • New York, NY
National Provider Identifier
1972066181
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704380360 Issued in MI
Practice address
294 W 92ND St. Apt 1C
New York, NY 10025-1002
Phone
(845) 519-7661
NPI assigned
Apr 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 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 4704380360 MI Primary
Registered Nurse 163W00000X 729279 NY

Addresses

Primary practice location

294 W 92ND St. Apt 1C
New York, NY 10025-1002

Mailing address

17 Driftwood Lane
Colts Neck, NJ 07722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211214001138 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052745239 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
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

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

Hospital & facility affiliations

  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 19, 2022 Accepting new patients
GLPS Staffing Solutions LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2021 Accepting new patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 15, 2022 Accepting new patients
Crnas of Michigan Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

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

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

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

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

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

Organizations & group practices 4

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 3

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": "1555113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1972066181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 DRIFTWOOD LANE",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "07722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 W 92ND ST. APT 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251002",
            "telephone_number": "845-519-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLON",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-13",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704380360",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "729279",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.