Individual provider Active NPI

Ron Poplyk, CRNA

  • Certified Registered Nurse Anesthetist
  • Yakima, WA
National Provider Identifier
1467463208
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60207660 Issued in WA
Practice address
406 S 30TH Ave
Suite 202
Yakima, WA 98902-3713
Phone
(509) 972-1051
Fax
(509) 972-4166
NPI assigned
Aug 10, 2006
Last updated
Mar 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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 264805-4406 UT
Certified Registered Nurse Anesthetist 367500000X AP60207660 WA Primary

Addresses

Primary practice location

406 S 30TH Ave
Suite 202
Yakima, WA 98902-3713

Mailing address

406 S 30TH Ave
Suite 202
Yakima, WA 98902-3713
Phone (509) 972-1051

Other identifiers 6

IdentifierTypeStateIssuer
190246100OtherUTDEPT OF LABOR
266523OtherUTALTIUS
68295OtherUTPEHP
QMP00000336801OtherUTMOLINA
78900OtherUTHEALTHY U
731714968RRNOtherUTEDUCATORS MUTUAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110413000752 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284655267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians
Evergreen Anesthesia Associates LLCGroup PAC ID 7113284530, 26 clinicians

Practice addresses (Care Compare)

2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8000

502 W 4TH Ave
Toppenish, WA 98948-1616
Phone (509) 837-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
264805-4406UTMDCertified Registered Nurse Anesthetist
AP60207660WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 6, 2022 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Jan 1, 2017 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Jan 1, 2017 Accepting new patients
Rocky Mountain Anesthesiology, PC Past Accepting new patients

Locations

1016 Tacoma Ave
Sunnyside, WA 98944
Phone (509) 823-6682

502 W 4th Ave
Toppenish, WA 98948
Phone (509) 575-5000

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

406 S 30th Ave
Ste 202
Yakima, WA 98902
Phone (509) 972-1051

Organizations & group practices 4

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 2

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1467463208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 S 30TH AVE",
            "address_2": "SUITE 202",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023713",
            "telephone_number": "509-972-1051",
            "fax_number": "509-972-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S 30TH AVE",
            "address_2": "SUITE 202",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023713",
            "telephone_number": "509-972-1051",
            "fax_number": "509-972-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPLYK",
        "first_name": "RON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "264805-4406",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60207660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "190246100",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "266523",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "68295",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "QMP00000336801",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY U",
            "identifier": "78900",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "731714968RRN",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.