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JOHN PEMBERTON CRNA
NPI 1093406514
Nurse Anesthetist, Certified Registered in West Bloomfield, MI

Active since May 16, 2023Accepts Medicare Assignment
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322(586) 286-0050 Get Directions Write a Review

NPPES record last updated: July 16, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 16, 2026, Aug 24, 2023, May 16, 2023 (3 updates tracked since 2023).

About John Pemberton Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN PEMBERTON CRNA (NPI 1093406514) is an individual nurse anesthetist, certified registered in West Bloomfield, Michigan, licensed in Michigan (4704327563) and active in the NPI registry since May 2023. He is affiliated with Beaumont Hospital - Farmington Hills, maintains a secondary practice location in Oak Park, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1093406514
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameJOHN PEMBERTONCredential: CRNA
Location Address6777 W MAPLE RDWest Bloomfield, MI 48322-3013
Mailing Address1 Ford Pl Ste 3aDetroit, MI 48202-3450 · (313) 874-4806
Phone(586) 286-0050
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateMay 16, 2023
Last NPPES UpdateJuly 16, 20263 updates tracked since enumeration
NPPES CertifiedJuly 16, 2026
✔ NPI 1093406514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in MI · 4704327563
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedRegistered NurseTaxonomy 163W00000X · License 4704327563 (MI)
6777 W MAPLE RD, West Bloomfield, MI 48322
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Secondary Practice Location 1

Location 123491 Norwood StOak Park, MI 48237-2203 · Phone (248) 495-9694

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

John Pemberton Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8325492663
PECOS Enrollment IDI20230920003715

Medicare Billing Reassignments

6

Medicare enrollment records show John Pemberton reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Novi Aas LLC
4.4 mi
Anesthesiology
43422 W OAKS DR # 332
Novi, MI 48377
  • Reassigned Medicare billing, Michigan enrollment
  • 192 clinicians in this Medicare group
NPI 1598176919 (248) 229-4658
West Michigan Aas LLC
4.7 mi
Anesthesiology
43422 W OAKS DR # 332
Novi, MI 48377
  • Reassigned Medicare billing, Michigan enrollment
  • 188 clinicians in this Medicare group
NPI 1295149227 (248) 229-4658
Northwestern Services, LLC
4.8 mi
Anesthesiology
30055 NORTHWESTERN HWY, SUITE L60
Farmington Hills, MI 48334
  • Reassigned Medicare billing, Michigan enrollment
  • 199 clinicians in this Medicare group
NPI 1083883649 (248) 865-6555
Botsford General Hospital
7.5 mi
Nurse Anesthetist, Certified Registered
28050 GRAND RIVER AVE
Farmington Hills, MI 48336
  • Reassigned Medicare billing, Michigan enrollment
  • 69 clinicians in this Medicare group
NPI 1235179664 (248) 471-8720
Henry Ford Health System
20 mi
Nurse Anesthetist, Certified Registered
2799 W GRAND BLVD
Detroit, MI 48202
  • Reassigned Medicare billing, Michigan enrollment
  • 306 clinicians in this Medicare group
NPI 1871666479 (313) 916-2600
Northstar Anesthesia Of Michigan III PLLC
995 mi
Pain Medicine
6225 N STATE HIGHWAY 161 STE 200
Irving, TX 75038
  • Reassigned Medicare billing, Michigan enrollment
  • 905 clinicians in this Medicare group
NPI 1972126209 (214) 687-0001

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Beaumont Hospital - Farmington Hills

Acute Care Hospitals · Farmington Hills, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230151
Location28050 Grand River AvenueFarmington Hills, MI 48336 · Oakland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48322 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IRB MEDICAL EQUIPMENT LLC
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
6777 W MAPLE RD, RM 60-01
WEST BLOOMFIELD, MI 48322
Oakland County (248) 862-7214
MELISSA ANNE BARACH AGCNS
Clinical Nurse Specialist
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322
Oakland County (989) 245-7466
ANNA CEDOZ CCC-SLP
Speech-Language Pathologist
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322
Oakland County (248) 325-1000
SAYEDUL ISLAM
Specialist/Technologist, Other (Surgical Assistant)
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322
Oakland County (800) 653-6568
MADISON SOKOL MOT
Occupational Therapist
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322
Oakland County (248) 325-3113
SARAH ANNE MATTAN PA
Physician Assistant (Medical)
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322
Oakland County (800) 653-6568
JENNIFER LEE FRANKLIN M.D.
Emergency Medicine
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322
Oakland County (843) 876-8023
NICOLE AURORA RADU-YAKOB CRNA
Nurse Anesthetist, Certified Registered
6777 W MAPLE RD
WEST BLOOMFIELD, MI 48322
Oakland County (248) 661-4100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Pemberton's NPI number?

The NPI number for John Pemberton is 1093406514. It was assigned to this individual provider in the NPPES registry on May 16, 2023.

Where is John Pemberton located?

John Pemberton practices at 6777 W Maple Rd, West Bloomfield, MI 48322. The listed phone number is (586) 286-0050.

What is John Pemberton's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is John Pemberton enrolled in Medicare?

Yes. John Pemberton is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for John Pemberton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Pemberton reassigns Medicare benefits to 6 organizations: Novi Aas LLC (Novi, MI), West Michigan Aas LLC (Novi, MI), Northwestern Services, LLC (Farmington Hills, MI), Botsford General Hospital (Farmington Hills, MI), Henry Ford Health System (Detroit, MI) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Pemberton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does John Pemberton accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list John Pemberton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is John Pemberton affiliated with any hospitals?

According to CMS data, John Pemberton is affiliated with Beaumont Hospital - Farmington Hills.

When was this NPI record last updated?

The NPPES record for John Pemberton was last updated on July 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.