Individual provider Active NPI

Dustin J Ulrich, CRNA

  • Certified Registered Nurse Anesthetist
  • Lee's Summit, MO
National Provider Identifier
1861232506
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2024020469 Issued in MO
Practice address
100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone
(816) 347-5097
Fax
(816) 347-5045
NPI assigned
May 30, 2024
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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 2024020469 MO Primary
Registered Nurse 163W00000X 2014038675 MO

Addresses

Primary practice location

100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000

Mailing address

PO Box 412431
Kansas City, MO 64141-2431
Phone (816) 347-5097

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240805000103 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163969411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Kansas School of Med (KC/Wich/Sal), 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes East Anesthesia Services PCGroup PAC ID 1850333477, 44 clinicians
Capital Anesthesia Solutions of Missouri LLCGroup PAC ID 1456764885, 75 clinicians

Practice addresses (Care Compare)

100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone (816) 347-5097

2316 E Meyer Blvd
HCA Research Medical Center
Kansas City, MO 64132-1136
Phone (816) 276-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014038675MOMDRegistered Nurse
2024020469MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes East Anesthesia Services,P.C. CurrentSince Jun 17, 2024 Accepting new patients

Locations

100 NE Saint Lukes Blvd
Lees Summit, MO 64086
Phone (816) 347-5097

120 NE Saint Lukes Blvd
Lees Summit, MO 64086
Phone (816) 347-5800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1861232506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412431",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641412431",
            "telephone_number": "816-347-5097",
            "fax_number": "816-347-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE SAINT LUKES BLVD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866000",
            "telephone_number": "816-347-5097",
            "fax_number": "816-347-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULRICH",
        "first_name": "DUSTIN",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2024020469",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2014038675",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.