Timothy J Dykstra, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

28206675A Issued in IN

Practice address

1201 N Main St
Crown Point, IN 46307-2716

Phone

(219) 757-6077

NPI assigned

Apr 30, 2013

Last updated

Apr 30, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northstar Anesthesia of Indiana LLCGroup PAC ID 1153576905, 130 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Northstar Anesthesia of Indiana LLC

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1043561541

  IN, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Northstar Anesthesia of Indiana II, LLC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1629475421

  IN, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northwest Indiana Radiation Oncology, PC

  • Specialist
  • Crown Point, IN
  • NPI 1487684395
  NPD (past)

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

• Franciscan Health Crown Point

  • General Acute Care Hospital
  • Crown Point, IN
  • NPI 1336205798
  Care Compare affiliation

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1104261510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9318 MONROE CT",
            "address_2": "APT 509",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463076216",
            "telephone_number": "708-691-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463072716",
            "telephone_number": "219-757-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28206675A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• U. Nalla B Durai, M.D.
• Dominique Dvojacki
• DVP Counseling and Behavioral Services , LLC
• Briana Dyer
• Mariliz Jimenez Dykstra, DPT
• Amy Lynn Eagens, OTR/L
• Chloe Edwards, RBT
• Julia Ann Edwards, NCSP, EIP
• Tiffany Nicole Edwards, LCSW
• Katie Lynn Eich, LMHC

• Certified Registered Nurse Anesthetist in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Certified Registered Nurse Anesthetist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.