NPIMap

Organization Active NPI

Northstar Anesthesia of Michigan III PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Irving, TX
National Provider Identifier
1972126209
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
NORTHSTAR ANESTHESIA OF MICHIGAN III PLLC
Practice address
6225 N State Highway 161 Ste 200
Irving, TX 75038-2241
Phone
(214) 687-0001
Fax
(972) 518-0001
NPI assigned
May 21, 2020
Last updated
May 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Brian P Woods, MD
Title
President, Clinical Services
Phone
(214) 687-0001

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Pain Medicine (Anesthesiology) Physician 207LP2900X Primary

Addresses

Primary practice location

6225 N State Highway 161 Ste 200
Irving, TX 75038-2241

Mailing address

6225 N State Highway 161 Ste 200
Irving, TX 75038-2241
Phone (239) 610-0775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200915001990 MI Part B Supplier - Clinic/Group Practice 7911325469 Receives reassigned benefits from 903 practitioners
Practice locations: Royal Oak, MI; Lenox, MI; Taylor, MI; Trenton, MI; Troy, MI; Wayne, MI; West Bloomfield, MI; Rochester Hills, MI…

National Provider Directory

National Provider Directory

Locations

15959 Hall Rd
Macomb, MI 48044
Phone (248) 964-5190

15959 Hall Rd
Ste 200
Macomb, MI 48044
Phone (586) 247-5300

1555 South Blvd E
Ste 220
Rochester Hills, MI 48307

Practitioners & affiliated clinicians

Practitioners 905

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 905

NPI Registry JSON

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1972126209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 N STATE HIGHWAY 161 STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382241",
            "telephone_number": "239-610-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 N STATE HIGHWAY 161 STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382241",
            "telephone_number": "214-687-0001",
            "fax_number": "972-518-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR ANESTHESIA OF MICHIGAN III PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-21",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT, CLINICAL SERVICES",
        "authorized_official_telephone_number": "214-687-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.