Individual provider Active NPI

Frederick Dimmel III, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Joseph, MO
National Provider Identifier
1497056808
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2007020499 Issued in MO
Practice address
5325 Faraon St
Saint Joseph, MO 64506-3488
Phone
(816) 271-6350
Fax
(816) 271-6753
NPI assigned
Nov 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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 2007020499 MO Primary

Addresses

Primary practice location

5325 Faraon St
Saint Joseph, MO 64506-3488

Mailing address

PO Box 410245
Kansas City, MO 64141-0245
Phone (913) 642-4900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120324000037 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880854124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Regional Medical CenterGroup PAC ID 6709772767, 394 clinicians

Practice addresses (Care Compare)

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-3500

901 Heartland Rd
Saint Joseph, MO 64506-6201

Hospital & facility affiliations

  • Mosaic Life Care at St Joseph Hospital, Saint Joseph, MO, CCN 260006

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
74.35
Promoting interoperability
100
Improvement activities
40
Cost
74.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007020499MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Regional Medical Center Current Accepting new patients
Heartland Regional Medical Center CurrentSince Jan 25, 2012 Accepting new patients

Locations

2016 S Main St
Maryville, MO 64468
Phone (660) 562-2525

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

5325 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-3500

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1213

Organizations & group practices 3

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 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": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1497056808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 410245",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641410245",
            "telephone_number": "913-642-4900",
            "fax_number": "913-381-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6350",
            "fax_number": "816-271-6753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMMEL",
        "first_name": "FREDERICK",
        "name_suffix": "III",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-16",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2007020499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.