| Lisa Licavoli, CRNA | |
|
1447 N Harrison St, Saginaw, MI 48602-4727 | |
| (989) 583-0000 | |
| Not Available |
| Full Name | Lisa Licavoli |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 23 Years |
| Location | 1447 N Harrison St, Saginaw, Michigan |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558339960 | NPI | - | NPPES |
| 430F364420 | Other | MI | BCBSM |
| 4606097 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 4704189302 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Healthcare | Owosso, MI | Hospital |
| St Joseph Mercy Oakland | Pontiac, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Eastern District Anesthesiology Pllc | 6507195419 | 40 |
| Covenant Medical Center Inc | 2769387778 | 494 |
| Memorial Hospital | 8527976497 | 208 |
| Anesthesia Associates Of Ann Arbor Pllc | 1355317223 | 216 |
| Entity Name | American Anesthesiology Of Michigan Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487609475 PECOS PAC ID: 5294648804 Enrollment ID: O20031110000617 |
| Entity Name | Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235160532 PECOS PAC ID: 8527976497 Enrollment ID: O20040122000907 |
| Entity Name | Northstar Anesthesia Of Michigan Ii Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437268026 PECOS PAC ID: 7911895164 Enrollment ID: O20040309000625 |
| Entity Name | Straith Hospital For Special Surgery |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548268436 PECOS PAC ID: 1153210067 Enrollment ID: O20040310001337 |
| Entity Name | Macomb Anesthesia Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639248206 PECOS PAC ID: 2860486388 Enrollment ID: O20040408001058 |
| Entity Name | Superior Anesthetists Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831144518 PECOS PAC ID: 5890784987 Enrollment ID: O20040512000785 |
| Entity Name | Henry Ford Macomb Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528130739 PECOS PAC ID: 7911808381 Enrollment ID: O20040522000104 |
| Entity Name | Anesthesia Associates Of Ann Arbor Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669581997 PECOS PAC ID: 1355317223 Enrollment ID: O20040902000916 |
| Entity Name | Surgical Centers Of Michigan Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1962463133 PECOS PAC ID: 1355393364 Enrollment ID: O20050218000062 |
| Entity Name | Ambulatory Anesthesia Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952350555 PECOS PAC ID: 5092729020 Enrollment ID: O20060130000526 |
| Entity Name | Northwestern Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215106679 PECOS PAC ID: 4486723657 Enrollment ID: O20080514000823 |
| Entity Name | Waterford Anesthesia, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376862474 PECOS PAC ID: 6901090489 Enrollment ID: O20101028000689 |
| Entity Name | Macomb Endoscopy Center Plc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1780923128 PECOS PAC ID: 1850536012 Enrollment ID: O20130319000064 |
| Entity Name | Eastern District Anesthesiology Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396397741 PECOS PAC ID: 6507195419 Enrollment ID: O20190830002837 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Licavoli, CRNA 3601 W 31 Mile Rd, 400 Fsc - Pcs, Royal Oak, MI 48073-6769 Ph: (248) 423-3144 | Lisa Licavoli, CRNA 1447 N Harrison St, Saginaw, MI 48602-4727 Ph: (989) 583-0000 |
Theresa L Jones, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1447 N Harrison St, Saginaw, MI 48602 Phone: 989-583-0000 | |
William J Zwiers, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 700 Cooper Ave, Saginaw, MI 48602 Phone: 989-583-6200 | |
Mr. Dominic James D'amore Iii, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1500 Weiss St, Saginaw, MI 48602 Phone: 989-497-2500 | |
Mr. Michael Dennis Romanow, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1447 N Harrison St, Saginaw, MI 48602 Phone: 989-583-2794 | |
Christine Ann Smith, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1447 N Harrison St, Saginaw, MI 48602 Phone: 989-583-4673 Fax: 989-583-4635 | |
Lynn Ann Barnhart, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 700 Cooper Ave, Saginaw, MI 48602 Phone: 989-258-1003 | |
Mrs. Trari Bowdish, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 700 Cooper Ave, Saginaw, MI 48602 Phone: 989-583-0000 |