Individual provider Active NPI

Joesina Manalel Wadehra

  • Certified Registered Nurse Anesthetist
  • Royal Oak, MI
National Provider Identifier
1992377972
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
20114080433 Issued in MI
Practice address
1240 Diamond CT Unit C
Royal Oak, MI 48067-3158
Phone
(248) 974-2187
NPI assigned
Jul 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 4704313315 MI
Certified Registered Nurse Anesthetist 367500000X 20114080433 MI Primary

Addresses

Primary practice location

1240 Diamond CT Unit C
Royal Oak, MI 48067-3158

Mailing address

1240 Diamond CT Unit C
Royal Oak, MI 48067-3158
Phone (248) 974-2187

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220323001902 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537554803 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Oakland College of Medicine and Surgery, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

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

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (214) 687-0001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704313315MIMDRegistered Nurse
20114080433MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Ann Arbor, PLLC Single Specialty CurrentSince Aug 15, 2024 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Single Specialty CurrentSince Jan 1, 2022 Accepting new patients
Alliance Anesthesia PLLC Single Specialty CurrentSince Apr 1, 2024 Accepting new patients
St Mary Mercy Hospital Crna Single Specialty CurrentSince Nov 1, 2024 Accepting new patients
Jawad a Shah, MD PC Single Specialty CurrentSince Apr 1, 2024 Accepting new patients
Jawad a Shah MD PC CurrentSince Apr 1, 2024 Accepting new patients

Locations

350 E Devon Ave
Itasca, IL 60143

2006 Hogback Rd
Ste 5
Ann Arbor, MI 48105
Phone (313) 712-4331

4800 S Saginaw St
Ste 1845
Flint, MI 48507
Phone (810) 275-9152

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

36650 5 Mile Rd
Ste 101
Livonia, MI 48154
Phone (734) 434-6262

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

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

11012 E 13 Mile Rd
Ste 112A
Warren, MI 48093
Phone (586) 573-6880

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

Organizations & group practices 6

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": "1625961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1992377972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 DIAMOND CT UNIT C",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673158",
            "telephone_number": "248-974-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 DIAMOND CT UNIT C",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673158",
            "telephone_number": "248-974-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADEHRA",
        "first_name": "JOESINA",
        "middle_name": "MANALEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-11",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704313315",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "20114080433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.