NPIMap

Individual provider Active NPI

Thomas J Plunkett Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Clarkston, MI
National Provider Identifier
1992815179
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704175416 Issued in MI
Practice address
5173 Iroquois CT
Clarkston, MI 48348-3059
Phone
(248) 394-0186
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4704175416 MI Primary

Addresses

Primary practice location

5173 Iroquois CT
Clarkston, MI 48348-3059

Mailing address

5173 Iroquois CT
Clarkston, MI 48348-3059
Phone (248) 394-0186

Other identifiers 1

IdentifierTypeStateIssuer
TP175416OtherMIBLUE CROSS OF MI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050621001027 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800831868 Reassigns benefits to 1 organization

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
Botsford General HospitalGroup PAC ID 2668385238, 46 clinicians

Practice addresses (Care Compare)

28050 Grand River Ave
Farmington Hills, MI 48336-5933
Phone (947) 522-1860

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.54 of 100Reported as group
Quality
93.24
Promoting interoperability
100
Improvement activities
40
Cost
79.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704175416MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Botsford General Hospital Nurse Anesthetist, Certified Registered CurrentSince Feb 8, 2008 Accepting new patients
Botsford General Hospital CurrentSince Feb 8, 2008 Accepting new patients
Novi Anesthesia Services PLC Past Accepting new patients
Straith Hospital for Special Surgery Past Accepting new patients
Ambulatory Anesthesia Care, PLLC Past Accepting new patients
St. Joseph Mercy Hospital Crna Group Nurse Anesthetist, Certified Registered Past Accepting new patients
Henry Ford Health River District Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Henry Ford Health Providence Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

3601 W 13 Mile Rd
Royal Oak, MI 48073

Organizations & group practices 8

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.

Hospital & facility affiliations 8

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992815179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5173 IROQUOIS CT",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483483059",
            "telephone_number": "248-394-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5173 IROQUOIS CT",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483483059",
            "telephone_number": "248-394-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUNKETT",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704175416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MI",
            "identifier": "TP175416",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.