MARY M MCMILLAN (CRNA) – Certified Registered Nurse Anesthetist, NPI 1487667838

MARY M MCMILLAN (CRNA) is a healthcare provider. based in Detroit, Michigan. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 4704138586 (MI). The NPI Number for MARY M MCMILLAN (CRNA) is 1487667838

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
MARY M MCMILLAN (CRNA)
NPI
1487667838
Phone
(586) 610-5523
Address
2799 W GRAND BLVD
Enumeration Date
15 August 2006
Last Update Date
10 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3139162600
Graduation Year
1996 (30 years ago)
PAC ID
9133203060
Group Practice PAC ID
0547178311
Professional Enrollment ID
I20080229000601
Address ID
MI482022608DE2799XBOUL400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,692 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MI

Provider Addresses for MARY M MCMILLAN (CRNA)

  • 2799 W GRAND BLVD

    DETROIT, MI 482022608

    Phone: (586) 610-5523

    Type: Location

  • 8762 MARQUETTE DR

    GROSSE ILE, MI 481381566

    Phone: (734) 755-8123

    Type: Mailing

  • Biddle Subdivision, Wyandotte, Wayne County, Michigan, United States

    WYANDOTTE, MI 481924668

    Phone: (734) 324-3697

    Fax: (734) 324-3425

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-02-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080229000601ICertified Registered Nurse Anesthetist (Crna)MITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00142Anesthesia for lens surgery4442$0
00400Anesthesia for other procedure on skin of arms, legs, and front body1111$0
View full utilization report →

Insurance plans in this area (ZIP 48202)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547178311View full group profile
NameSpecialtyState
-MI
Gastroenterology, Internal MedicinePA
Certified Registered Nurse Anesthetist (Crna)MI
Clinical Social WorkerMI
-MI
Physician AssistantMI
Qualified AudiologistMI
O P H T H A L M O L O G YMI
-MI
-MI

Reviews

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Frequently asked questions

What is the registry number for MARY M MCMILLAN (CRNA)?
The registry entry for MARY M MCMILLAN (CRNA) shows NPI 1487667838.
Should I treat MARY M MCMILLAN (CRNA) as an active provider?
Patients and plans typically see MARY M MCMILLAN (CRNA) as active in the national extract.
What type of care does MARY M MCMILLAN (CRNA) provide?
MARY M MCMILLAN (CRNA)'s profile centers on Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Can patients visit MARY M MCMILLAN (CRNA) in Detroit, Michigan?
For routing, start with Detroit, Michigan for MARY M MCMILLAN (CRNA), then verify phone and hours locally.
Why is information missing for MARY M MCMILLAN (CRNA)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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