Active NPI
Tyler S Kunkel, CRNA
- Certified Registered Nurse Anesthetist
- Fargo, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R40332
- Practice address
- 801 Broadway N
Fargo, ND 58102-3641 - Phone
- (701) 234-6259
- Fax
- (701) 234-7334
- NPI assigned
- Jan 15, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R40332 | ND | Primary |
Addresses
Primary practice location
801 Broadway N
Fargo, ND 58102-3641
Mailing address
PO Box 2168
Fargo, ND 58107-2168
Phone (701) 234-2119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000
Hospital & facility affiliations
- Sanford Medical Center Fargo
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- Quality
- 71.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.68
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R40332 | ND | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients |
Locations
801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
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 and National Provider Directory roles.
-
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1245519081
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
-
- Ambulatory Surgical Clinic/Center
- Bemidji, MN
- NPI 1093876922
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1154788503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2168",
"city": "FARGO",
"state": "ND",
"postal_code": "581072168",
"telephone_number": "701-234-2119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 BROADWAY N",
"city": "FARGO",
"state": "ND",
"postal_code": "581023641",
"telephone_number": "701-234-6259",
"fax_number": "701-234-7334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUNKEL",
"first_name": "TYLER",
"middle_name": "S",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-15",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ND",
"license": "R40332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; 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.