Lakeshore Anesthesia Staffing LLC
NPI 1255781019ActiveOrganization· Nurse Anesthetist, Certified Registered· Saint Joseph, MI
Nurse Anesthetist, Certified Registered in Saint Joseph, Michigan, registered in NPPES in June 2016. The authorized official on file is Marcus A. Gardiner, CRNA, Sole Mbr. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1255781019 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 13, 2016 |
| Last updated in NPPES | Jun 13, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | E8460D | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MI) |
|---|
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