LISA MARIE COLOSIMO (NPI# 1356640718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356640718 |
| Entity Type | Individual |
| Full Name | LISA MARIE COLOSIMO |
| Credential | D.O. |
| Practice Address |
2799 W Grand Blvd Detroit MI 48202-2608 |
| Practice Telephone | 3134601985 |
| Mailing Telephone | 3134601985 |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2017-03-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LC0200X |
Anesthesiology Specialization: Critical Care Medicine |
5101019287 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2799 W GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48202-2608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235132069 | Donna Prince | Radiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2005-05-24 |
| 1790386704 | Alexandria L Blevins | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-11-05 |
| 1255932430 | Amy Katlyn Carion | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-11-04 | |
| 1871194415 | Alexandria Denise Roberts | Physical Therapist | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2020-11-02 |
| 1174121420 | John Charles Sanno | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2020-10-09 |
| 1932706991 | Fallon J Awe | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-02 |
| 1922615145 | Chelsea Elizabeth Owen | Nurse Anesthetist, Certified Registered | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-01 |
| 1275130395 | Zana Latkovac | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-01 |
| 1487260030 | Jessica Lee Moret | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-09-18 |
| 1932713237 | Lucas Costa Santos | Anesthesiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
| 1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
| 1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
| Find all providers in zip 48202 | ||||
| Taxonomy Code | 207LC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Critical Care Medicine |
| An anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801129218 | Nicholas Sabah Yeldo | Anesthesiology | 2799 W Grand Blvd, 343 Clara Ford Pavillion, Detroit, MI 48202-2689 | 2009-09-16 |
| 1699940429 | Jaspreet Sangha | Anesthesiology | 3990 John R, Anesthesiology Deptmt, Box 162, Room 2901, Detroit, MI 48201 | 2008-04-23 |
| 1447428362 | Bradley D Tilford | Anesthesiology | 3901 Beaubien, Children's Hospital of Mi, Detroit, MI 48201 | 2008-02-13 |
| 1396819801 | Morris Brown | Anesthesiology | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2006-11-17 |
| 1255370441 | William T Peruzzi | Anesthesiology | 1 Ford Pl, Suite 2e Henry Ford Health System, Detroit, MI 48202-3450 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588924344 | Dashanique Williams | Anesthesiology | 42225 Fairview Dr, Canton, MI 48187-3716 | 2012-05-25 |
| 1043410400 | Ajay Anand Khilanani | Anesthesiology | 100 Michigan St. Ne, Grand Rapids, MI 49503 | 2007-07-23 |
| 1528018256 | Emad Alatassi | Anesthesiology | 13251 E 10 Mile Rd Ste 800, Warren, MI 48089-2077 | 2006-05-11 |
| 1386188761 | Brian Trethowan | Anesthesiology | 100 Michigan St Ne, Suite 8861, Grand Rapids, MI 49503-2560 | 2016-12-05 |
| 1245675024 | Payal Boss | Anesthesiology | 3333 Evergreen Dr Ne, Grand Rapids, MI 49525-9493 | 2013-05-07 |
| 1861770851 | Carrie E Harvey | Anesthesiology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2011-07-26 |
| 1881987006 | Penny Wilton | Anesthesiology | 100 Michigan St Ne, Suite 8861, Grand Rapids, MI 49503-2560 | 2011-05-20 |
| 1417247099 | Rajat Praveenchandra Pareek | Anesthesiology | 100 Michigan St Ne, Mc 117, Grand Rapids, MI 49503 | 2011-04-15 |
| 1750689121 | Michigan Critical Care Anesthesiology | Anesthesiology | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2011-03-08 |
| 1417266339 | Nicole Renee Tantipitham | Anesthesiology | 1500 E Medical Center Dr, 1h247 University Hospital, Ann Arbor, MI 48109-5048 | 2010-09-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.