Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Thomas Shadaya

Individual provider Critical Care Medicine Registered Nurse · NPI 1265165120

Thomas Shadaya is a Certified Registered Nurse Anesthetist (CRNA) in Detroit, Michigan. Qualified in 2022, 4 years ago. Practices with Henry Ford Health Providence Hospital, a 350-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
4
Licensed in
MI
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

259 Mack Ave
Detroit, MI 48201-2427
Phone: (313) 577-1716
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 4704272654 (MI)
Critical Care Medicine Registered Nurse Taxonomy 163WC0200X · Licence 4704272654 (MI)

Record details

NPI number1265165120
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 7, 2022
Last updated in NPPESMarch 19, 2025
Certification dateMarch 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Henry Ford Health Providence Hospital — 350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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