Mrs Tia Dominique Agboruche, in Detroit, MI - Medicare Certified Registered Nurse Anesthetist (crna)

Mrs Tia Dominique Agboruche, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Detroit, Michigan. She graduated from nursing school in 2021 and has 5 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Ascension Genesys Hospital, Capital Area Anesthesia Pc, Southwest Ohio Anesthesia Consultants Llc and her current practice location is 20418 Binder St, Detroit, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 333-4038.

Mrs Tia Dominique Agboruche is licensed to practice in Michigan (license number 4704311021) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1013687029.

Contact Information

	Mrs Tia Dominique Agboruche,
	20418 Binder St, Detroit, MI 48234-1913
	(313) 333-4038
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Tia Dominique Agboruche
Gender	Female
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	5 Years
Location	20418 Binder St, Detroit, 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.

Medical Education and Training:

Mrs Tia Dominique Agboruche graduated from nursing school in 2021

NPI Data:

NPI Number: 1013687029
Provider Enumeration Date: 09/20/2021
Last Update Date: 10/07/2024

Medicare PECOS Information:

PECOS PAC ID: 5799170007
Enrollment ID: I20220324000403

Medical Identifiers

Medical identifiers for Mrs Tia Dominique Agboruche such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013687029	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	4704311021 (Michigan)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	APRN.CRNA.0021121 (Ohio)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	4704311021 (Michigan)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Genesys Regional Medical Center - Health Park	Grand blanc, MI	Hospital
Mclaren Greater Lansing	Lansing, MI	Hospital
Mercy St Vincent Medical Center	Toledo, OH	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Ascension Genesys Hospital	2062323033	83
Capital Area Anesthesia Pc	8628975968	34
Southwest Ohio Anesthesia Consultants Llc	6901700640	331

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. Mrs Tia Dominique Agboruche allows following entities to bill medicare on her behalf.

Entity Name	Capital Area Anesthesia Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1538105010 PECOS PAC ID: 8628975968 Enrollment ID: O20031216000210

Entity Name	Ascension Genesys Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558517367 PECOS PAC ID: 2062323033 Enrollment ID: O20081029000720

Entity Name	Northstar Anesthesia Of Michigan Iii Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI 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. Mrs Tia Dominique Agboruche 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 Address	Practice Location Address
Mrs Tia Dominique Agboruche, 20418 Binder St, Detroit, MI 48234-1913 Ph: (313) 333-4038	Mrs Tia Dominique Agboruche, 20418 Binder St, Detroit, MI 48234-1913 Ph: (313) 333-4038

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Detroit, MI

Kimberly Dawn Harris, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3990 John R St, Detroit, MI 48201 Phone: 313-745-8521
Caroline L Talbert, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3990 John R St, Detroit, MI 48201 Phone: 313-745-7600 Fax: 952-442-3620
Kyle Krupa, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-2600
Lisa Zetuna, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-2600
Dr. Timothy Turner, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-8078
Ms. Laura Lynn Rivera, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-2600
Elizabeth Anne Ranella, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 4201 Saint Antoine St, Detroit, MI 48201 Phone: 952-442-9770 Fax: 952-442-3630

Mrs Tia Dominique Agboruche, - Medicare Certified Registered Nurse Anesthetist (crna) in Detroit, MI