Active NPI
Roger Tatarian
- Certified Registered Nurse Anesthetist
- Appleton, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 200090-30
- Practice address
- 1818 N Meade St
Appleton, WI 54911-3454 - Phone
- (920) 731-4101
- NPI assigned
- Aug 11, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 200090-30 | WI | Primary |
Addresses
Primary practice location
1818 N Meade St
Appleton, WI 54911-3454
Mailing address
203 Desplaine Rd
De Pere, WI 54115-3726
Other practice location 1
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-3388
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | rtatarian180646@direct.myadvocateaurora.org | Direct | |
| Direct Messaging Address | rtatarian180646@direct.myadvocateaurora.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 731-4101
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200090-30 | WI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baycare Clinic LLP | Current | Accepting new patients | |
| Association of Hospital Anesthesiologists SC | Current | Accepting new patients | |
| Baycare Clinic LLP | Current | Accepting new patients |
Locations
1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101
2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388
164 N Broadway
Green Bay, WI 54303
Phone (920) 965-4055
2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400
1035 Kepler Dr
Green Bay, WI 54311
736 Ford St
Kimberly, WI 54136
130 2nd St
#A107
Neenah, WI 54956
130 2nd St
Neenah, WI 54956
Phone (920) 729-2063
719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066
Interoperability endpoints
- rtatarian180646@direct.myadvocateaurora.org
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.
-
- Anesthesiology Physician
- Neenah, WI
- NPI 1720076474
-
- Emergency Medicine Physician
- Green Bay, WI
- NPI 1588609648
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1134490758
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1740920909
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1497119218
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1689038408
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1831773589
-
- General Acute Care Hospital
- Appleton, WI
- NPI 1902832306
-
- General Acute Care Hospital
- Fond Du Lac, WI
- NPI 1912721002
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1912880329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1710431309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 DESPLAINE RD",
"city": "DE PERE",
"state": "WI",
"postal_code": "541153726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1818 N MEADE ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549113454",
"telephone_number": "920-731-4101"
}
],
"practiceLocations": [
{
"address_1": "2845 Greenbrier Rd",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543116519",
"country_code": "US",
"telephone_number": "920-288-3388",
"fax_number": "920-288-3370",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TATARIAN",
"first_name": "ROGER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-11",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "200090-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2845 Greenbrier Rd",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543116519",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rtatarian180646@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2845 Greenbrier Rd",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543116519",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rtatarian180646@direct.myadvocateaurora.org",
"affiliation": "N",
"address_1": "2845 Greenbrier Rd",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543116519",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.