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NICOLE BLACK CRNA
NPI 1376203802
Nurse Anesthetist, Certified Registered in Ypsilanti, MI

Active since December 24, 2021Accepts Medicare Assignment
5301 MCAULEY DR, YPSILANTI, MI 48197(734) 712-3456 Get Directions Write a Review

NPPES record last updated: December 24, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nicole Black Crna NPPES

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

NICOLE BLACK CRNA (NPI 1376203802) is an individual nurse anesthetist, certified registered in Ypsilanti, Michigan, licensed in Michigan (139623) and active in the NPI registry since December 2021. She is affiliated with Trinity Health Ann Arbor Hospital and is a graduate of Other (2021).

NPPES Registry Identity

NPI1376203802
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameNICOLE BLACKCredential: CRNA
Location Address5301 MCAULEY DRYpsilanti, MI 48197-1051
Mailing Address203 E Forest AveYpsilanti, MI 48198-3075 · (517) 375-1808
Phone(734) 712-3456
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateDecember 24, 2021
NPPES CertifiedDecember 23, 2021
✔ NPI 1376203802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in MI · 139623
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.
5301 MCAULEY DR, Ypsilanti, MI 48197
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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

Nicole Black 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 ID7618363276
PECOS Enrollment IDI20220407000156

Medicare Billing Reassignment

Medicare enrollment records show Nicole Black reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sjmhs Anesthesia Services
3.9 mi
Anesthesiology
5301 E HURON RIVER DR
Ypsilanti, MI 48197
  • Reassigned Medicare billing, Michigan enrollment
  • 151 clinicians in this Medicare group
NPI 1508201617 (734) 712-3456

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.

Trinity Health Ann Arbor Hospital

Acute Care Hospitals · Ann Arbor, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230156
Location5301 E Huron River DrAnn Arbor, MI 48106 · Washtenaw County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48197 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.

LINDSEY NICOLE FARAH-BRUNNER M.D.
Pediatrics
5301 MCAULEY DR
YPSILANTI, MI 48197
Washtenaw County (734) 712-3325
BRIANNA KATHRYN BREITNER KRUEGER
Nurse Practitioner (Psychiatric/Mental Health)
5301 MCAULEY DR
YPSILANTI, MI 48197
Washtenaw County (734) 712-6101
DR. SANDRA B CADICHON MD
Pediatrics (Neonatal-Perinatal Medicine)
5301 MCAULEY DR
YPSILANTI, MI 48197
Washtenaw County (734) 712-3327
JASON MICHAEL HOGARTH CRNA
Nurse Anesthetist, Certified Registered
5301 MCAULEY DR
YPSILANTI, MI 48197
Washtenaw County (734) 712-3456
ALEXANDRA STROIA DO
Student in an Organized Health Care Education/Training Program
5301 MCAULEY DR
YPSILANTI, MI 48197
Washtenaw County (734) 712-3456
BLAKE MALCOLM ELY PA-C
Physician Assistant
5301 MCAULEY DR
YPSILANTI, MI 48197
Washtenaw County (248) 697-1548
AARON MARAUGHA CRNA
Nurse Anesthetist, Certified Registered
5301 MCAULEY DR
YPSILANTI, MI 48197
Washtenaw County (734) 712-3456
MRS. HEIDI GRACE MOCANU RN
Registered Nurse
5301 MCAULEY DR
YPSILANTI, MI 48197
Washtenaw County (734) 712-3456

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 Nicole Black's NPI number?

The NPI number for Nicole Black is 1376203802. It was assigned to this individual provider in the NPPES registry on December 24, 2021.

Where is Nicole Black located?

Nicole Black practices at 5301 Mcauley Dr, Ypsilanti, MI 48197. The listed phone number is (734) 712-3456.

What is Nicole Black's specialty?

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

Is Nicole Black enrolled in Medicare?

Yes. Nicole Black 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 organization bills Medicare for Nicole Black's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Black reassigns Medicare benefits to Sjmhs Anesthesia Services (Ypsilanti, MI). The 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 Nicole Black's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Nicole Black affiliated with any hospitals?

According to CMS data, Nicole Black is affiliated with Trinity Health Ann Arbor Hospital.

When was this NPI record last updated?

The NPPES record for Nicole Black was last updated on December 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.