Individual provider Active NPI

Lydia Vanwormer

  • Certified Registered Nurse Anesthetist
  • Tucson, AZ
National Provider Identifier
1750778221
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
699344 Issued in NY
Practice address
2200 S Houghton Rd
Tucson, AZ 85748-7632
Phone
(520) 543-6100
NPI assigned
Apr 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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 257519 NC
Certified Registered Nurse Anesthetist 367500000X 699344 NY Primary

Addresses

Primary practice location

2200 S Houghton Rd
Tucson, AZ 85748-7632

Mailing address

2017 Copper Leaf Pkwy
Apt. 207
Durham, NC 27703-7749
Phone (850) 501-8316

Other practice location 1

525 E 68th St
New York, NY 10065-4870
Phone (212) 746-5454

Other practice location 2

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-5000

Other names 1

  • Lydia Wunsch Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OK, AZ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180115000804 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951606185 Reassigns benefits to 2 organizations
I20230314001674 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951606185 Reassigns benefits to 2 organizations
I20241203002022 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951606185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Duke University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest HBP Medical Services LLCGroup PAC ID 8921356536, 278 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

6200 N la Cholla Blvd
Tucson, AZ 85741-3529
Phone (520) 229-2657

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.53 of 100Reported as group
Quality
90
Improvement activities
20
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
257519NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 5, 2023 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Antigua Anesthesia Management, LLC CurrentSince Dec 23, 2024 Accepting new patients
Western Oklahoma Anesthesia Consultants PLLC CurrentSince May 6, 2023 Accepting new patients
Northwest HBP Medical Services LLC CurrentSince Nov 1, 2024 Accepting new patients
Northern Anesthesia Providers PC CurrentSince Oct 1, 2023 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Sep 15, 2025 Accepting new patients

Locations

2735 Silver Creek Rd
Bullhead City, AZ 86442
Phone (520) 763-2273

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

2200 S Houghton Rd
Tucson, AZ 85748
Phone (520) 287-5728

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

430 N Monte Vista St
Ada, OK 74820
Phone (580) 226-1251

2825 Parklawn Dr
Oklahoma City, OK 73110
Phone (405) 245-1453

100 SE 59th St
Oklahoma City, OK 73129
Phone (405) 364-9789

10512 N 110th East Ave
Owasso, OK 74055
Phone (918) 272-1172

111 N Bailey St
Pryor, OK 74361
Phone (918) 824-7791

3701 E Main St
Weatherford, OK 73096
Phone (580) 772-5551

900 17th St
Woodward, OK 73801
Phone (405) 610-4411

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 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": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1750778221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 COPPER LEAF PKWY",
            "address_2": "APT. 207",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277037749",
            "telephone_number": "850-501-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 S HOUGHTON RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857487632",
            "telephone_number": "520-543-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 E 68th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100654870",
            "country_code": "US",
            "telephone_number": "212-746-5454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Jefferson Ave SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034502",
            "country_code": "US",
            "telephone_number": "616-685-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANWORMER",
        "first_name": "LYDIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "257519",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "699344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYDIA",
            "last_name": "WUNSCH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.