Individual provider Active NPI

Tara Munroe, CRNA

  • Certified Registered Nurse Anesthetist
  • Bozeman, MT
National Provider Identifier
1194907543
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN-100960 Issued in MT
Practice address
925 Highland Blvd Ste 1180
Bozeman, MT 59715-6905
Phone
(406) 582-4963
Fax
(706) 396-3252
NPI assigned
Nov 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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 087174 CT
Certified Registered Nurse Anesthetist 367500000X APRN-100960 MT Primary

Addresses

Primary practice location

925 Highland Blvd Ste 1180
Bozeman, MT 59715-6905

Mailing address

400 10TH St E
Waconia, MN 55387-4552
Phone (888) 209-0305

Other practice location 1

1747 Poly Dr
Billings, MT 59102-1728
Phone (888) 209-0305

Other identifiers 1

IdentifierTypeStateIssuer
1194907543MedicaidMT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130121000173 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810065836 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1747 Poly Dr
Billings, MT 59102-1728
Phone (203) 535-8313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003948CTMDProfessional Counselor
087174CTMDCertified Registered Nurse Anesthetist
APRN-100960MTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gallatin Valley Anesthesia Associates PC CurrentSince Jan 1, 2013 Accepting new patients
Northern Montana Hospital CurrentSince Jul 15, 2013 Accepting new patients
Northern Montana Hospital Current Accepting new patients
Northern Montana Hospital CurrentSince Jul 15, 2013 Accepting new patients
Diamond Anesthesia, PC Nurse Anesthetist, Certified Registered CurrentSince Jul 15, 2019 Accepting new patients
Intercity Radiology, PC PastSince Jan 1, 2013 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

1747 Poly Dr
Billings, MT 59102
Phone (406) 219-0700

925 Highland Blvd
Ste 1180
Bozeman, MT 59715
Phone (406) 582-4963

202 Prospect Dr
Glendive, MT 59330
Phone (406) 345-3306

30 13th St
Havre, MT 59501
Phone (406) 262-1302

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1194907543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 10TH ST E",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "888-209-0305",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 HIGHLAND BLVD STE 1180",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156905",
            "telephone_number": "406-582-4963",
            "fax_number": "706-396-3252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1747 Poly Dr",
            "address_purpose": "LOCATION",
            "city": "Billings",
            "state": "MT",
            "postal_code": "591021728",
            "country_code": "US",
            "telephone_number": "888-209-0305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNROE",
        "first_name": "TARA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "087174",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "APRN-100960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194907543",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.