NPIMap

Individual provider Active NPI

Matthew Delane Poppe, CRNA

  • Certified Registered Nurse Anesthetist
  • Sioux City, IA
National Provider Identifier
1346695558
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
D142886 Issued in IA
Practice address
2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone
(712) 279-3500
NPI assigned
Apr 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X D142886 IA Primary

Addresses

Primary practice location

2720 Stone Park Blvd
Sioux City, IA 51104-3734

Mailing address

2871 S Saint Marys St
Sioux City, IA 51106-3428
Phone (605) 310-8794

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190520000893 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941591218 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health ServicesGroup PAC ID 6103729066, 151 clinicians

Practice addresses (Care Compare)

1000 W 4TH St
Suite 8
Yankton, SD 57078-3700

501 Summit St
Yankton, SD 57078-3855
Phone (605) 668-8795

Hospital & facility affiliations

  • Avera Sacred Heart Hospital Hospital, Yankton, SD, CCN 430012

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health Services CurrentSince Oct 1, 2018 Accepting new patients
Sanford Health Network CurrentSince Jan 29, 2024 Accepting new patients
Sanford Health Network Current Accepting new patients
Sacred Heart Health Services Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2018 Accepting new patients
Sanford Health Network CurrentSince Jan 29, 2024 Accepting new patients
Sacred Heart Health Services Current Accepting new patients
Siouxland Anesthesiology, LTD Nurse Anesthetist, Certified Registered CurrentSince Dec 20, 2023 Accepting new patients

Locations

101 Tower Rd
Ste 201
North Sioux City, SD 57049
Phone (605) 232-3332

600 N Sioux Point Rd
North Sioux City, SD 57049
Phone (605) 217-4320

20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1346695558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2871 S SAINT MARYS ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511063428",
            "telephone_number": "605-310-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 STONE PARK BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043734",
            "telephone_number": "712-279-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPPE",
        "first_name": "MATTHEW",
        "middle_name": "DELANE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D142886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.

Verify at the official NPI Registry.