Lisa M Wodtke, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Warren, MI

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Lisa M Wodtke, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Warren, Michigan. She graduated from nursing school in 1993 and has 32 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Northstar Anesthesia Of Michigan Iii Pllc and her current practice location is 11800 E 12 Mile Rd, Warren, Michigan. You can reach out to her office (for appointments etc.) via phone at (586) 573-5260.

Lisa M Wodtke is licensed to practice in Michigan (license number 4704163773) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1962569152.

Contact Information

Lisa M Wodtke, CRNA
11800 E 12 Mile Rd,
Warren, MI 48093-3472
(586) 573-5260
(586) 573-5364

Map and Direction




Provider's Profile

Full NameLisa M Wodtke
GenderFemale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience32 Years
Location11800 E 12 Mile Rd, Warren, Michigan
Accepts Medicare AssignmentsMay be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Lisa M Wodtke graduated from nursing school in 1993
  NPI Data:
  • NPI Number: 1962569152
  • Provider Enumeration Date: 01/03/2007
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 2961568381
  • Enrollment ID: I20090309000606

Medical Identifiers

Medical identifiers for Lisa M Wodtke such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1962569152NPI-NPPES
3153030MedicaidMI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 4704163773 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Beaumont Hospital, TroyTroy, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Northstar Anesthesia Of Michigan Iii Pllc7911325469522

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lisa M Wodtke allows following entities to bill medicare on her behalf.
Entity NameAscension Macomb Oakland Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396789434
PECOS PAC ID: 7315859725
Enrollment ID: O20031105000692
Entity NameWilliam Beaumont Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1811044878
PECOS PAC ID: 9335051093
Enrollment ID: O20040312000217
Entity NameAscension Macomb Oakland Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871793505
PECOS PAC ID: 7315859725
Enrollment ID: O20080604000742
Entity NameEastside Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235365289
PECOS PAC ID: 4486790219
Enrollment ID: O20091008000624
Entity NameMichigan Crnas Staffing Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1851666424
PECOS PAC ID: 7416105226
Enrollment ID: O20120920000441
Entity NameWest Michigan Aas Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1295149227
PECOS PAC ID: 9931324076
Enrollment ID: O20140707000372
Entity NameNovi Aas Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598176919
PECOS PAC ID: 1557587847
Enrollment ID: O20140722002052
Entity NameRochester Medical Associates Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396398681
PECOS PAC ID: 8729318704
Enrollment ID: O20190918002717
Entity NameNorthstar Anesthesia Of Michigan Iii Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972126209
PECOS PAC ID: 7911325469
Enrollment ID: O20200915001990

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa M Wodtke is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lisa M Wodtke, CRNA
11800 E 12 Mile Rd,
Warren, MI 48093-3472

Ph: (586) 573-5260		Lisa M Wodtke, CRNA
11800 E 12 Mile Rd,
Warren, MI 48093-3472

Ph: (586) 573-5260

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Warren, MI

Kimberly A Manzaroli, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 11800 E 12 Mile Rd, Warren, MI 48093
Phone: 586-573-5260    Fax: 586-573-5364
Toleka Regina Taylor, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093
Phone: 586-576-4031    
Metodija Naumovski, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 11800 E 12 Mile Rd, Warren, MI 48093
Phone: 586-573-5260    Fax: 586-573-5364
David J Van Dam, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 11800 E 12 Mile Rd, Warren, MI 48093
Phone: 586-573-5260    Fax: 586-573-5364
Mr. Romulo Gasmen Pascua, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 21230 Dequindre Rd, Warren, MI 48091
Phone: 734-765-2921    
Norbert Kadler, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 11800 E 12 Mile Rd, Warren, MI 48093
Phone: 586-573-5260    Fax: 586-573-5364
Ms. Diane Marie Pokorski, CRNA
Nurse Anesthetist - CR
Medicare: May Accept Medicare Assignments
Practice Location: 11800 E 12 Mile Rd, Warren, MI 48093
Phone: 586-612-4446    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.