Tyler Jacob McDonald, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209023442 Issued in IL

Practice address

1000 Health Center Dr
Mattoon, IL 61938-4644

Phone

(217) 258-2440

Fax

(217) 258-2186

NPI assigned

Mar 3, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Missouri Baptist Medical CenterGroup PAC ID 3476461955, 123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarah Bush Lincoln Health Center Hospital, Mattoon, IL, CCN 140189
• Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252
• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment Care Compare group NPD
• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Medicare reassignment Care Compare group NPD
• Missouri Baptist Medical Center

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1609658905

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesia Pain Services LLC

  • Anesthesiology Physician
  • Streator, IL
  • NPI 1790075489
  Medicare reassignment NPD
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  dba St. Anthony's Memorial Hospital

  • General Acute Care Hospital
  • Effingham, IL
  • NPI 1306800602
  Medicare reassignment NPD
• Midwest Anesthesia Providers S.C

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1295189082

  IL

  Medicare reassignment
• Specialists in Anesthesia PC

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1689619280

  IL

  Medicare reassignment
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Sarah Bush Lincoln Health Center

  dba FCH Greenville Family Medicine Clinic

  • Rural Health Clinic/Center
  • Greenville, IL
  • NPI 1811858970
  NPD
• North American Partners in Anesthesia (Illinois), LLC

  • Anesthesiology Physician
  • Oak Park, IL
  • NPI 1699032524
  NPD (past)

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

• Northwest Community Hospital

  dba Endeavor Health Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1578932869
  Care Compare affiliation
• Northwest Community Hospital

  dba Endeavor Health Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1770531600
  Care Compare affiliation
• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Care Compare affiliation
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1619562584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384644",
            "telephone_number": "217-258-2440",
            "fax_number": "217-258-2186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "503 N Maple St",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624012006",
            "country_code": "US",
            "telephone_number": "217-342-2121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 E Carpenter St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627692006",
            "country_code": "US",
            "telephone_number": "217-544-6464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Health Center Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619384644",
            "country_code": "US",
            "telephone_number": "217-238-3425",
            "fax_number": "217-238-3770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3015 N Ballas Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312329",
            "country_code": "US",
            "telephone_number": "314-996-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "TYLER",
        "middle_name": "JACOB",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-03",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041460929",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2021040417",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209023442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmcdonald322482@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "800 E Carpenter St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627692006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "endpointDescription": "BJC",
            "affiliationName": "MISSOURI BAPTIST MEDICAL CENTER",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Morgan McClellan
• Alexandra Christine McCollum, PA-C
• Renee Erica McCray, MHP, BS
• Andrew McDevitt, APRN
• Ashley McDonald, BA
• Darlene McGary, H.S.
• Lindsay McGuire
• Mary H McGuire, APN,BC
• Laura McHenry, BS
• David McIntyre, BA

• Certified Registered Nurse Anesthetist in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.