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

Mrs Tia Dominique Agboruche, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Detroit, Michigan. She graduated from nursing school in 2021 and has 3 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 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 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 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 NameMrs Tia Dominique Agboruche
GenderFemale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience3 Years
Location20418 Binder St, Detroit, 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:
  • 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.
IdentifierTypeStateIssuer
1013687029NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 4704311021 (Michigan)Secondary
367500000XNurse Anesthetist, Certified Registered APRN.CRNA.0021121 (Ohio)Secondary
367500000XNurse Anesthetist, Certified Registered 4704311021 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Beaumont Hospital Royal OakRoyal oak, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Northstar Anesthesia Of Michigan Iii Pllc7911325469510

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 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. 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 AddressPractice 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


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Ms. Laura Lynn Rivera, CRNA
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Practice Location: 2799 W Grand Blvd, Detroit, MI 48202
Phone: 313-916-2600    

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.