Lisa Licavoli, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Royal Oak, MI

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Lisa Licavoli, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Royal Oak, Michigan. She graduated from nursing school in 2003 and has 22 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Anesthesia Associates Of Ann Arbor Pllc, Eastern District Anesthesiology Pllc and her current practice location is 3601 W 31 Mile Rd, 400 Fsc - Pcs, Royal Oak, Michigan. You can reach out to her office (for appointments etc.) via phone at (248) 423-3144.

Lisa Licavoli is licensed to practice in Michigan (license number 4704189302) 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 1558339960.

Contact Information

Lisa Licavoli, CRNA
3601 W 31 Mile Rd, 400 Fsc - Pcs,
Royal Oak, MI 48073-6769
(248) 423-3144
Not Available

Map and Direction




Provider's Profile

Full NameLisa Licavoli
GenderFemale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience22 Years
Location3601 W 31 Mile Rd, Royal Oak, Michigan
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Lisa Licavoli graduated from nursing school in 2003
  NPI Data:
  • NPI Number: 1558339960
  • Provider Enumeration Date: 03/10/2006
  • Last Update Date: 12/04/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 0244201697
  • Enrollment ID: I20040802000442

Medical Identifiers

Medical identifiers for Lisa Licavoli such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1558339960NPI-NPPES
430F364420OtherMIBCBSM
4606097MedicaidMI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 4704189302 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
St Joseph Mercy OaklandPontiac, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Anesthesia Associates Of Ann Arbor Pllc1355317223147
Eastern District Anesthesiology Pllc650719541932

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 Licavoli allows following entities to bill medicare on her behalf.
Entity NameAmerican Anesthesiology Of Michigan Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487609475
PECOS PAC ID: 5294648804
Enrollment ID: O20031110000617
Entity NameAnesthesia Services Group, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437268992
PECOS PAC ID: 0042124885
Enrollment ID: O20031117000499
Entity NameNorthstar Anesthesia Of Michigan Ii Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437268026
PECOS PAC ID: 7911895164
Enrollment ID: O20040309000625
Entity NameStraith Hospital For Special Surgery
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548268436
PECOS PAC ID: 1153210067
Enrollment ID: O20040310001337
Entity NameMacomb Anesthesia Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1639248206
PECOS PAC ID: 2860486388
Enrollment ID: O20040408001058
Entity NameSuperior Anesthetists Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1831144518
PECOS PAC ID: 5890784987
Enrollment ID: O20040512000785
Entity NameHenry Ford Macomb Hospital Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1528130739
PECOS PAC ID: 7911808381
Enrollment ID: O20040522000104
Entity NameAnesthesia Associates Of Ann Arbor Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669581997
PECOS PAC ID: 1355317223
Enrollment ID: O20040902000916
Entity NameSurgical Centers Of Michigan Llc
Entity TypePart B Supplier - Ambulatory Surgical Center
Entity IdentifiersNPI Number: 1962463133
PECOS PAC ID: 1355393364
Enrollment ID: O20050218000062
Entity NameAmbulatory Anesthesia Associates Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1952350555
PECOS PAC ID: 5092729020
Enrollment ID: O20060130000526
Entity NameNorthwestern Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215106679
PECOS PAC ID: 4486723657
Enrollment ID: O20080514000823
Entity NameWaterford Anesthesia, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376862474
PECOS PAC ID: 6901090489
Enrollment ID: O20101028000689
Entity NameMacomb Endoscopy Center Plc
Entity TypePart B Supplier - Ambulatory Surgical Center
Entity IdentifiersNPI Number: 1780923128
PECOS PAC ID: 1850536012
Enrollment ID: O20130319000064
Entity NameEastern District Anesthesiology Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396397741
PECOS PAC ID: 6507195419
Enrollment ID: O20190830002837
Entity NameProper Anesthesia Services Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275292245
PECOS PAC ID: 5294127676
Enrollment ID: O20220114001028

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 Licavoli 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 Licavoli, CRNA
3601 W 31 Mile Rd, 400 Fsc - Pcs,
Royal Oak, MI 48073-6769

Ph: (248) 423-3144		Lisa Licavoli, CRNA
3601 W 31 Mile Rd, 400 Fsc - Pcs,
Royal Oak, MI 48073-6769

Ph: (248) 423-3144

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Royal Oak, MI

Ban Batu, CRNA
Nurse Anesthetist - CR
Medicare: May Accept Medicare Assignments
Practice Location: 3601 W 13 Mile Rd, Royal Oak, MI 48073
Phone: 248-423-3144    
Amie Hamper,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 3601 W 13 Mile Rd, Royal Oak, MI 48073
Phone: 248-898-7784    Fax: 248-898-8181
Michelle Glaeser, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 3601 W 13 Mile Rd, 400 Fsc - Pcs, Royal Oak, MI 48073
Phone: 248-423-3144    
Thomas Lundblad, CRNA
Nurse Anesthetist - CR
Medicare: May Accept Medicare Assignments
Practice Location: 3601 W 13 Mile Rd, 400 Fsc - Pcs, Royal Oak, MI 48073
Phone: 248-423-3144    
Patricia Ljubic, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 3601 W 13 Mile Rd, 400 Fsc - Pcs, Royal Oak, MI 48073
Phone: 248-423-3144    
Catherine Wolfson, CRNA
Nurse Anesthetist - CR
Medicare: May Accept Medicare Assignments
Practice Location: 3601 W. 13 Mile Rd, 400 Fsc-pcs, Royal Oak, MI 48073
Phone: 248-423-2481    
Nancy Berner, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 3601 W 13 Mile Rd, Beaumont Hospital - Royal Oak, Royal Oak, MI 48073
Phone: 248-898-7784    Fax: 248-898-8181

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.