Individual provider Active NPI

Matthew Wyatt Sims, CRNA

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1528317484
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
041351362 Issued in IL
Practice address
1653 W Congress Pkwy
Department of Anesthesia
Chicago, IL 60612-3833
Phone
(312) 942-5000
NPI assigned
Sep 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 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 041351362 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
Department of Anesthesia
Chicago, IL 60612-3833

Mailing address

4858 N Hermitage Ave
Apt. 1a
Chicago, IL 60640-4125
Phone (312) 952-1928

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130620000526 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648419705 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granville Health SystemGroup PAC ID 1052223757, 78 clinicians

Practice addresses (Care Compare)

1010 College St
Oxford, NC 27565-2507
Phone (919) 690-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041351362ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2013 Accepting new patients
360 Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 12, 2025 Accepting new patients
Granville Health System CurrentSince Apr 29, 2025 Accepting new patients
Nash Hospitals Inc CurrentSince Jan 1, 2022 Accepting new patients
Granville Health System Nurse Anesthetist, Certified Registered CurrentSince Apr 29, 2025 Accepting new patients
American Anesthesiology of North Carolina, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2013 Accepting new patients
Nash Hospitals Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients

Locations

117 E Kings Hwy
Eden, NC 27288
Phone (336) 627-6181

1010 College St
Oxford, NC 27565
Phone (919) 623-5115

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

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 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": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1528317484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4858 N HERMITAGE AVE",
            "address_2": "APT. 1A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404125",
            "telephone_number": "312-952-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "DEPARTMENT OF ANESTHESIA",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMS",
        "first_name": "MATTHEW",
        "middle_name": "WYATT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041351362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.