Individual provider Active NPI

Tia Marie Zdych, CRNA

  • Certified Registered Nurse Anesthetist
  • Crown Point, IN
National Provider Identifier
1144804212
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28200892A Issued in IN
Practice address
1201 S Main St
Crown Point, IN 46307-8481
Phone
(219) 738-2100
NPI assigned
May 5, 2021
Last updated
Mar 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28200892A IN Primary
Registered Nurse 163W00000X 28200892A IN

Addresses

Primary practice location

1201 S Main St
Crown Point, IN 46307-8481

Mailing address

1777 E 105TH Ave
Crown Point, IN 46307-7078
Phone (219) 508-1293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211101001421 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749678308 Reassigns benefits to 3 organizations
I20220912003749 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749678308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
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)

5454 Hohman Ave
Hammond, IN 46320-1931
Phone (219) 932-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28200892AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 13, 2021 Accepting new patients
Sda Consultants PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 18, 2023 Accepting new patients
Northstar Anesthesia of Indiana II, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 31, 2021 Accepting new patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 10, 2022 Accepting new patients

Locations

13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

12750 Saint Francis Dr
Crown Point, IN 46307
Phone (219) 738-2100

12800 Mississippi Pkwy
Crown Point, IN 46307
Phone (219) 662-5560

9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

500 Arcade Ave
Ste 100
Elkhart, IN 46514
Phone (574) 389-5683

5454 Hohman Ave
Hammond, IN 46320
Phone (219) 933-2077

1101 Michigan Ave
Logansport, IN 46947
Phone (574) 753-1475

701 Superior Ave
Munster, IN 46321
Phone (219) 922-4200

Organizations & group practices 4

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": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1144804212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 E 105TH AVE",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077078",
            "telephone_number": "219-508-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078481",
            "telephone_number": "219-738-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZDYCH",
        "first_name": "TIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28200892A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28200892A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.