Individual provider Active NPI

Michael E Tadlock, CRNA

  • Certified Registered Nurse Anesthetist
  • Pipestone, MN
National Provider Identifier
1609837350
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
223779-0 Issued in MN
Practice address
916 4TH Ave. SW
Pipestone, MN 56164
Phone
(507) 825-5811
Fax
(563) 556-8334
NPI assigned
Mar 31, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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 D103531 IA
Certified Registered Nurse Anesthetist 367500000X 223779-0 MN Primary

Addresses

Primary practice location

916 4TH Ave. SW
Pipestone, MN 56164

Mailing address

916 4TH Ave. SW
Pipestone, MN 56164
Phone (507) 825-5811

Other identifiers 2

IdentifierTypeStateIssuer
44335300MedicaidWI
0453241MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041228000793 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799743498 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sioux Center HealthGroup PAC ID 9032027495, shared by 6 NPIs, 36 clinicians
Anesthesia Consultants PCGroup PAC ID 6103716626, 20 clinicians
Floyd Valley HealthcareGroup PAC ID 2769385475, shared by 5 NPIs, 35 clinicians

Practice addresses (Care Compare)

1101 9TH St SE
Sioux Center, IA 51250-2501
Phone (712) 722-1271

2730 Pierce St
Sioux City, IA 51104-3796
Phone (712) 294-7777

714 Lincoln St NE
Le Mars, IA 51031-3314
Phone (712) 546-3338

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D103531IAMDCertified Registered Nurse Anesthetist
223779-0MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sioux Center Health CurrentSince Aug 6, 2018 Accepting new patients
Sioux Center Health Current Accepting new patients
Floyd Valley Healthcare Current Accepting new patients
Floyd Valley Healthcare CurrentSince Oct 31, 2017 Accepting new patients
Sioux Center Health CurrentSince Aug 6, 2018 Accepting new patients
Floyd Valley Healthcare CurrentSince Oct 31, 2017 Accepting new patients
Hegg Memorial Hospital Current Accepting new patients
Hawarden Regional Healthcare Current Accepting new patients
Dubuque Anesthesia Services, PC Nurse Anesthetist, Certified Registered PastSince May 25, 2021 Accepting new patients
Dubuque Anesthesia Services, PC PastSince May 16, 2021 Accepting new patients

Locations

1111 11th St
Hawarden, IA 51023
Phone (712) 551-3100

714 Lincoln St NE
Le Mars, IA 51031
Phone (712) 546-3338

1202 21st Ave
Rock Valley, IA 51247
Phone (712) 476-8000

1101 9th St SE
Sioux Center, IA 51250
Phone (712) 722-1271

Organizations & group practices 12

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 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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1609837350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 4TH AVE. SW",
            "city": "PIPESTONE",
            "state": "MN",
            "postal_code": "56164",
            "telephone_number": "507-825-5811",
            "fax_number": "563-556-8334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 4TH AVE. SW",
            "city": "PIPESTONE",
            "state": "MN",
            "postal_code": "56164",
            "telephone_number": "507-825-5811",
            "fax_number": "563-556-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADLOCK",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D103531",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "223779-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44335300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0453241",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pipestone, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.