Individual provider Active NPI

Neal R. Popichak, CRNA

  • Certified Registered Nurse Anesthetist
  • Joplin, MO
National Provider Identifier
1659635217
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
132744 Issued in MT
Practice address
102 West 32ND St.
Joplin, MO 64804-0000
Phone
(417) 347-3659
NPI assigned
Jun 28, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 98776 WV
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X 132744 MT Primary
Certified Registered Nurse Anesthetist 367500000X 2012019388 MO

Addresses

Primary practice location

102 West 32ND St.
Joplin, MO 64804-0000

Mailing address

1101 26TH St S
Great Falls, MT 59405-5161
Phone (406) 731-8888

Other practice location 1

327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone (681) 342-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190213001802 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587815030 Reassigns benefits to 2 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
CMSC LLCGroup PAC ID 5890602494, 92 clinicians

Practice addresses (Care Compare)

3010 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 216-8000

Hospital & facility affiliations

  • Great Falls Clinic Hospital Hospital, Great Falls, MT, CCN 270086
  • Benefis Hospitals Inc Hospital, Great Falls, MT, CCN 270012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012019388MOMDCertified Registered Nurse Anesthetist
132744MTMDCertified Registered Nurse Anesthetist
98776WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
CMSC, LLC Multi-Specialty CurrentSince Jul 31, 2024 Accepting new patients
Northstar Anesthesia of Montana Multi-Specialty CurrentSince Sep 1, 2021 Accepting new patients

Locations

3010 15th Ave S
Great Falls, MT 59405
Phone (406) 771-3095

1509 29th St S
Great Falls, MT 59405
Phone (406) 771-3500

Organizations & group practices 2

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 4

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1659635217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 26TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055161",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WEST 32ND ST.",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648040000",
            "telephone_number": "417-347-3659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "WV",
            "postal_code": "263309006",
            "country_code": "US",
            "telephone_number": "681-342-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POPICHAK",
        "first_name": "NEAL",
        "middle_name": "R.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "98776",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "132744",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2012019388",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.