Lisa Licavoli is a Royal Oak, Michigan based nurse anesthetist with 22 years of experience as Anesthesia Administration. She completed she graduation in 2003. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Lisa Licavoli is 4704189302 for Anesthesia Administration in Michigan. Her current practice location is 3601 W 31 Mile Rd, 400 Fsc - Pcs, Royal Oak. Patients can reach her at 248-423-3144. Lisa Licavoli is CRNA with specialization in Anesthesia Administration and she NPI number (Unique professional ID assigned by NPPES) is 1558339960. Lisa Licavoli is a certified 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.
Complete Profile:
Lisa Licavoli speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Anesthesia Administration
Credentials:
CRNA
Experience:
22+ years
Medical School Attended:
Other
Graduation Year:
2003
Gender:
Female
Accepts Medicare Assignment:
Yes
Practice Address:
3601 W 31 Mile Rd, 400 Fsc - Pcs, Royal Oak, Michigan, 48073-6769
Phone:
248-423-3144
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
0244201697
Enrollment ID:
I20040802000442
NPI Number:
1558339960
NPI Enumeration Date:
10 Mar, 2006
NPI Last Update On:
04 Dec, 2012
Medical Licenses:
Nurses can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lisa Licavoli are as mentioned below.
License Number
Specialization
State
Status
4704189302
Anesthesia Administration
Michigan
Primary
Hospital Affiliation:
Surgeons are affiliated to many hospitals whom they worked with in the past or are presently working with. One surgeon can be affiliated to four to five hospitals at a time.
Hospital Name (CCN)
State
Hospital Type
St Joseph Mercy Oakland (230029)
Pontiac, MI
Acute Care Hospital
Straith Hospital For Special Surgery (230071)
Southfield, MI
Acute Care Hospital
Group Practice:
Group practices are run by a group of physicians who share their premises and other resources. Following list states all the group name
with which Lisa Licavoli has association with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Anesthesia Associates Of Ann Arbor Pllc (1355317223)
153
Eastern District Anesthesiology Pllc (6507195419)
30
Henry Ford Macomb Hospital Corporation (7911808381)
249
Straith Hospital For Special Surgery (1153210067)
25
Other Medical Identifiers:
Other legacy medical identifiers associated with Lisa Licavoli such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
430F364420
Other
Michigan
BCBSM
4606097
Medicaid
Michigan
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
3601 W 31 Mile Rd, 400 Fsc - Pcs Royal Oak, Michigan
Zip:
48073-6769
Phone Number:
248-423-3144
Fax Number:
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Patients can reach Lisa Licavoli at 3601 W 31 Mile Rd, 400 Fsc - Pcs, Royal Oak, Michigan or can call to book an appointment on 248-423-3144.
Comments/ Reviews:
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 March, 2025.