Kyle M.E. Ellison, C.R.N.A.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R144605-8 Issued in MN

Practice address

200 1St St SW
Rochester, MN 55905-0001

Phone

(507) 284-2511

NPI assigned

Apr 24, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prairie Ridge Hospital and Health ServicesGroup PAC ID 0648222349, 90 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lake Region Healthcare Corporation Hospital, Fergus Falls, MN, CCN 240052
• Prairie Ridge Hospital and Health Services Hospital, Elbow Lake, MN, CCN 241379

Merit-based Incentive Payment System (MIPS)

Final score

88.64 of 100Reported as group

Quality

86.84

Promoting interoperability

100

Improvement activities

40

Cost

75.29

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

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.

• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Critical Access Hospital
  • Elbow Lake, MN
  • NPI 1407838329
  Medicare reassignment Care Compare group NPD
• Lake Region Healthcare Corporation

  • General Acute Care Hospital
  • Fergus Falls, MN
  • NPI 1093713372
  NPD
• Lake Region Healthcare Corporation

  • Chiropractor
  • Fergus Falls, MN
  • NPI 1265148480
  NPD
• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Critical Access Hospital
  • Fergus Falls, MN
  • NPI 1285525436
  NPD
• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Durable Medical Equipment & Medical Supplies
  • Fergus Falls, MN
  • NPI 1942191119
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Critical Access Hospital
  • Fergus Falls, MN
  • NPI 1285525436
  Care Compare affiliation
• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Critical Access Hospital
  • Elbow Lake, MN
  • NPI 1407838329
  Care Compare affiliation

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1417122078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "KYLE",
        "middle_name": "M.E.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R144605-8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - RAIL ROAD",
            "identifier": "P00787799",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad Richard Ellis, MSW, LICSW
• Jacob Kyle Ellis, MD
• Mary Ann Ellis, DNP, APRN, CNP
• Megan Mae Ellis, DO
• Nakita Elaine Ellis, MD
• Martin Gerard Ellman, DPM
• Marilyn Ellringer
• Lisa Louise Ellsworth, P.A.
• Arianna Elm, MSN, RN
• Shiva Elmaadawi

• Certified Registered Nurse Anesthetist in Rochester, MN
• Providers in Rochester, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; 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.