LISA M WODTKE CRNA
NPI 1962569152
Nurse Anesthetist, Certified Registered in Warren, MI
About Lisa M Wodtke Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LISA M WODTKE CRNA (NPI 1962569152) is an individual nurse anesthetist, certified registered in Warren, Michigan, licensed in Michigan (4704163773) and active in the NPI registry since January 2007. She is affiliated with Beaumont Hospital, Troy and is a graduate of Other (1993).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lisa M Wodtke Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
8Medicare enrollment records show Lisa Wodtke reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Warren, MI 48093
- Reassigned Medicare billing, Michigan enrollment
- Also billed through NPI 1871793505 (Michigan)
- 78 clinicians in this Medicare group
Saint Clair Shores, MI 48081
- Reassigned Medicare billing, Michigan enrollment
- 99 clinicians in this Medicare group
Royal Oak, MI 48073
- Reassigned Medicare billing, Michigan enrollment
- 278 clinicians in this Medicare group
Rochester Hills, MI 48307
- Reassigned Medicare billing, Michigan enrollment
- 43 clinicians in this Medicare group
Novi, MI 48377
- Reassigned Medicare billing, Michigan enrollment
- 192 clinicians in this Medicare group
Novi, MI 48377
- Reassigned Medicare billing, Michigan enrollment
- 188 clinicians in this Medicare group
Anderson, SC 29621
- Reassigned Medicare billing, South Carolina enrollment
- 269 clinicians in this Medicare group
Irving, TX 75038
- Reassigned Medicare billing, Michigan enrollment
- 905 clinicians in this Medicare group
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 3
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Beaumont Hospital, Troy
Acute Care Hospitals · Troy, MIMedicare 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.
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.
WARREN, MI 48093
WARREN, MI 48093
WARREN, MI 48093
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 Lisa Wodtke's NPI number?
The NPI number for Lisa Wodtke is 1962569152. It was assigned to this individual provider in the NPPES registry on January 3, 2007.
Where is Lisa Wodtke located?
Lisa Wodtke practices at 11800 E 12 Mile Rd, Warren, MI 48093. The listed phone number is (586) 573-5260.
What is Lisa Wodtke's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Lisa Wodtke enrolled in Medicare?
Yes. Lisa Wodtke is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Lisa Wodtke's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Wodtke reassigns Medicare benefits to 8 organizations: Henry Ford Health Macomb Oakland Hospital (Warren, MI), Eastside Group LLC (Saint Clair Shores, MI), William Beaumont Hospital (Royal Oak, MI), Rochester Medical Associates, PLLC (Rochester Hills, MI), Novi Aas LLC (Novi, MI) and 3 more organizations, 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 Lisa Wodtke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Lisa Wodtke affiliated with any hospitals?
According to CMS data, Lisa Wodtke is affiliated with Beaumont Hospital, Troy.
When was this NPI record last updated?
The NPPES record for Lisa Wodtke 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.
# Lisa M Wodtke, CRNA · NPI 1962569152
Nurse Anesthetist, Certified Registered physician in Warren, Michigan. Individual provider, active in the CMS NPPES registry since January 3, 2007.
## Identity
- **NPI:** 1962569152 (Entity type: Individual)
- **Enumerated:** January 3, 2007
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 4704163773 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 11800 E 12 MILE RD, Warren, MI 48093-3472
- **Phone:** (586) 573-5260 · **Fax:** (586) 573-5364
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** 8 organizations under Medicare reassignment (form CMS-855R): Henry Ford Health Macomb Oakland Hospital (NPI 1396789434, Warren, MI); Eastside Group LLC (NPI 1235365289, Saint Clair Shores, MI); William Beaumont Hospital (NPI 1811044878, Royal Oak, MI); Rochester Medical Associates, PLLC (NPI 1396398681, Rochester Hills, MI); Novi Aas LLC (NPI 1598176919, Novi, MI); and 3 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1993
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicaid 3153030 (MI)
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Source: [NPI Profile](https://npiprofile.com/npi/1962569152) · Data from the CMS NPPES public registry.