Tia Dominique Agboruche
NPI 1013687029ActiveIndividual· Nurse Anesthetist, Certified Registered· Detroit, MI
Nurse Anesthetist, Certified Registered with Southwest Ohio Anesthesia Consultants LLC and 1 other group, practicing in Detroit, Michigan. Medicare paid $8,368 for services to 83 patients in 2024. Lists Ascension Genesys Hospital as a hospital affiliation.
Overview
| NPI | 1013687029 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Sep 20, 2021 |
| Last updated in NPPES | Oct 7, 2024 |
| Certified by provider | Oct 7, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | 4704311021 | MI |
| Registered Nurse | 163W00000X | 4704311021 | MI |
| Nurse Anesthetist, Certified Registered | 367500000X | APRN.CRNA.0021121 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (MI); Practitioner - Certified Registered Nurse Anesthetist (CRNA) (OH) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 83 |
|---|---|
| Services billed | 83 across 38 procedure codes |
| Paid by Medicare | $8,368 |
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Certified Registered Nurse Anesthetist (Crna) |
Medical groups
- Southwest Ohio Anesthesia Consultants LLCCincinnati, OH · 361 clinicians
- Henry Ford Health Genesys HospitalGrand Blanc, MI · 84 clinicians
Hospital affiliation
- Ascension Genesys HospitalGrand Blanc, MI
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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