Individual provider Active NPI

Michael Paul Tennysen, RN

  • Certified Registered Nurse Anesthetist
  • Warsaw, NY
National Provider Identifier
1225522956
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
123550 Issued in NY
Practice address
400 N Main St
Warsaw, NY 14569-1025
Phone
(585) 786-2233
NPI assigned
Jun 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 666795 NY
Registered Nurse 163W00000X 7178358-3102 UT
Certified Registered Nurse Anesthetist 367500000X 123550 NY Primary

Addresses

Primary practice location

400 N Main St
Warsaw, NY 14569-1025

Mailing address

3711 Timberline Dr
Canandaigua, NY 14424-8385
Phone (585) 905-4112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190417001129 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921349127 Reassigns benefits to 3 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
Upstate New York Medical Professional CorporationGroup PAC ID 8022405380, 4 clinicians

Practice addresses (Care Compare)

400 N Main St
Warsaw, NY 14569-1025
Phone (585) 786-8940

5000 Campuswood Dr
Suite 200
East Syracuse, NY 13057-1268
Phone (315) 234-6677

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.09 of 100Reported as group
Quality
97.07
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7178358-3102UTMDRegistered Nurse
123550NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Gastroenterological Associates PC CurrentSince Mar 11, 2024 Accepting new patients
Upstate New York Medical Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Jan 28, 2022 Accepting new patients
Geneva General Hospital, Inc Current Accepting new patients
Geneva General Hospital, Inc CurrentSince Oct 1, 2020 Accepting new patients
Geneva General Hospital Inc CurrentSince Oct 1, 2020 Accepting new patients
Syracuse Gastroenterological Associates.PC CurrentSince Mar 11, 2024 Accepting new patients

Locations

5000 Campuswood Dr
Ste 100
East Syracuse, NY 13057
Phone (315) 234-6687

5000 Campuswood Dr
Ste 200
East Syracuse, NY 13057

196 North St
Geneva, NY 14456
Phone (315) 787-4156

739 Irving Ave
Ste 430
Syracuse, NY 13210

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

400 N Main St
Warsaw, NY 14569
Phone (585) 786-1555

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, 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": "1529107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1225522956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 TIMBERLINE DR",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144248385",
            "telephone_number": "585-905-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145691025",
            "telephone_number": "585-786-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNYSEN",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-16",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "666795",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "7178358-3102",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "123550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; 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.