Organization Active NPI

Tidal Anesthesia, PLLC

  • Certified Registered Nurse Anesthetist
  • Bellevue, WA
National Provider Identifier
1245074046
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
TIDAL ANESTHESIA, PLLC
Practice address
1110 112TH Ave NE
Bellevue, WA 98004-4509
Phone
(425) 450-0880
NPI assigned
Jun 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Thomas Swenson, CRNANPI 1114352663
Title
Crna
Phone
(206) 802-8421

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1110 112TH Ave NE
Bellevue, WA 98004-4509

Mailing address

4555 54TH Ave SW
Seattle, WA 98116
Phone (206) 802-8421

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240919000116 WA Part B Supplier - Clinic/Group Practice 2365983277 Receives reassigned benefits from 1 practitioner
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1245074046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 54TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98116",
            "telephone_number": "206-802-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 112TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044509",
            "telephone_number": "425-450-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDAL ANESTHESIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "SWENSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CRNA",
        "authorized_official_telephone_number": "206-802-8421",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.