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THOMAS JAKUBCZAK CRNA
NPI 1477561629
Nurse Anesthetist, Certified Registered in Detroit, MI

Active since August 04, 2006
100/100
CMS Quality Rating
3990 JOHN R ST, DETROIT, MI 48201(952) 442-9770 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Thomas Jakubczak Crna NPPES

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

THOMAS JAKUBCZAK CRNA (NPI 1477561629) is an individual nurse anesthetist, certified registered in Detroit, Michigan, licensed in Michigan (4704144957) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1477561629
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameTHOMAS JAKUBCZAKCredential: CRNA
Location Address3990 JOHN R STDetroit, MI 48201-2018
Mailing AddressPo Box 67000, Dept 203401Detroit, MI 48267-0002 · (952) 442-9770 · Fax (952) 442-3630
Phone(952) 442-9770
Sole ProprietorNo
Enumeration DateAugust 4, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1477561629 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 · 4704144957
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.
3990 JOHN R ST, Detroit, MI 48201
Open in Google Maps ↗

Other Identifiers 2

OtherTJ144957MI · Blue Cross Of Mi
Medicare ID-Type UnspecifiedN24360095MI

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, Priority Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Thomas Jakubczak Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

6

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

Northland Radiology Inc
11 mi
Diagnostic Radiology
20905 GREENFIELD RD, SUITE 105
Southfield, MI 48075
  • Reassigned Medicare billing, Michigan enrollment
  • 47 clinicians in this Medicare group
NPI 1386804060 (248) 569-0296
Ambulatory Anesthesia Associates, PC
41 mi
Anesthesiology
718 N MACOMB ST
Monroe, MI 48162
  • Reassigned Medicare billing, Michigan enrollment
  • 109 clinicians in this Medicare group
NPI 1952350555 (734) 240-8400
Great Lakes Eye Surgery Center LLC
87 mi
Ambulatory Surgical
2393 SCHUST RD
Saginaw, MI 48603
  • Reassigned Medicare billing, Michigan enrollment
  • 17 clinicians in this Medicare group
NPI 1265542849 (989) 793-2820
Psj Anesthesia PC
109 mi
Nurse Anesthetist, Certified Registered
16001 W 9 MILE RD
Southfield, MI 48075
  • Reassigned Medicare billing, Michigan enrollment
  • 209 clinicians in this Medicare group
NPI 1275905796 (248) 849-3000
Northstar Anesthesia Of Michigan III PLLC
1,008 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
Northstar Anesthesia Of Michigan PLLC
1,008 mi
Anesthesiology
6225 N STATE HIGHWAY 161 STE 200
Irving, TX 75038
  • Reassigned Medicare billing, Michigan enrollment
  • 369 clinicians in this Medicare group
NPI 1871986372 (214) 687-0675

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for other procedure or exam of knee joint using an endoscope 01400
Anesthesia for a knee joint procedure or exam using an endoscope involves administering medication to numb the area or put you in a sleep-like state. This ensures you don't feel pain during the procedure. The endoscope, a thin tube with a camera, allows the doctor to view the knee joint internally without making large incisions.
12 services11 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality88.26
Improvement Activities40

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.

KIMBERLY DAWN HARRIS CRNA
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-8521
CAROLINE L TALBERT CRNA
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-7600
CHISAOKWU DURU
Anesthesiology
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-7233
MR. MOHAMED IBRAHIM BAZZI
Occupational Therapist
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (810) 333-1822
DR. SAMIR F FULEIHAN M.D.
Anesthesiology
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-8521
DR. KAMAL K NANGIA
Emergency Medicine
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-8040
TODD E HAMILTON CRNA
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-7600
MITCHELL R BRADLEY CRNA
Nurse Anesthetist, Certified Registered
3990 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-7600

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 Thomas Jakubczak's NPI number?

The NPI number for Thomas Jakubczak is 1477561629. It was assigned to this individual provider in the NPPES registry on August 4, 2006.

Where is Thomas Jakubczak located?

Thomas Jakubczak practices at 3990 John R St, Detroit, MI 48201. The listed phone number is (952) 442-9770.

What is Thomas Jakubczak's specialty?

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

Is Thomas Jakubczak enrolled in Medicare?

Yes. Thomas Jakubczak is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Thomas Jakubczak's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Jakubczak reassigns Medicare benefits to 6 organizations: Northland Radiology Inc (Southfield, MI), Ambulatory Anesthesia Associates, PC (Monroe, MI), Great Lakes Eye Surgery Center LLC (Saginaw, MI), Psj Anesthesia PC (Southfield, MI), Northstar Anesthesia Of Michigan III PLLC (Irving, TX) 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 Thomas Jakubczak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Thomas Jakubczak accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Thomas Jakubczak 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.

When was this NPI record last updated?

The NPPES record for Thomas Jakubczak was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.