Individual provider Active NPI

Kyle P. Noorlander, CRNA

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1023672318
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
61748 Issued in ID
Practice address
1055 N Curtis Rd
Boise, ID 83706-1309
Phone
(208) 367-2559
NPI assigned
Apr 23, 2019
Last updated
Nov 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 83133 NE
Certified Registered Nurse Anesthetist 367500000X 61748 ID Primary

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1309

Mailing address

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-6416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190715002617 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143555029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

575 Pole Line Rd W
Twin Falls, ID 83301-9998
Phone (208) 814-9200

746 N College Rd
Twin Falls, ID 83301-3486

775 Pole Line Rd W
Twin Falls, ID 83301-5820

801 Pole Line Rd W
Twin Falls, ID 83301-5810

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.09 of 100Reported as group
Quality
77.1
Promoting interoperability
100
Improvement activities
40
Cost
73.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
83133NEMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Clinic LLC CurrentSince Jan 1, 2021 Accepting new patients
Boise Anesthesia, P a Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2019 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1023672318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061309",
            "telephone_number": "208-367-6416",
            "fax_number": "208-367-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061309",
            "telephone_number": "208-367-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOORLANDER",
        "first_name": "KYLE",
        "middle_name": "P.",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-23",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "83133",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "61748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.