Active NPI
Tyler William Shimek
- Certified Registered Nurse Anesthetist
- Green Bay, WI
National Provider Identifier
1902416480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 131883
- Practice address
- 835 S Van Buren St
Green Bay, WI 54301-3526 - Phone
- (920) 901-9496
- NPI assigned
- Aug 9, 2020
- Last updated
- Dec 21, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 131883 | WI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | WI |
Addresses
Primary practice location
835 S Van Buren St
Green Bay, WI 54301-3526
Mailing address
3014 Quarry Park Dr Apt 4
De Pere, WI 54115-8192
Phone (920) 901-9496
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tshimek289273@ewd.direct.hshs.org | Direct |
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, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 433-0111
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 74.22 of 100
- Quality
- 69.67
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 131883 | WI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Bay Anesthesia Assoc. SC | Current | Accepting new patients |
Locations
225 S Executive Dr
Brookfield, WI 53005
Phone (262) 787-4026
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
Bin 88263
Milwaukee, WI 53288
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Green Bay, WI
- NPI 1023065836
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1649246877
-
dba St Vincent Hospital
- General Acute Care Hospital
- Green Bay, WI
- NPI 1114908001
-
dba St. Vincent Regional Cancer Center
- Hematology & Oncology Physician
- Sheboygan, WI
- NPI 1831784636
Hospital
-
dba St. Vincent Regional Cancer Center
- Hematology & Oncology Physician
- Green Bay, WI
- NPI 1184004236
Hospital
-
dba St. Vincent Regional Cancer Center
- Hematology & Oncology Physician
- Oconto Falls, WI
- NPI 1750760740
Hospital
-
dba St. Vincent Regional Cancer Center
- Hematology & Oncology Physician
- Sturgeon Bay, WI
- NPI 1760861751
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640044800000",
"number": "1902416480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3014 QUARRY PARK DR APT 4",
"city": "DE PERE",
"state": "WI",
"postal_code": "541158192",
"telephone_number": "920-901-9496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 S VAN BUREN ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013526",
"telephone_number": "920-901-9496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMEK",
"first_name": "TYLER",
"middle_name": "WILLIAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-09",
"last_updated": "2021-12-21",
"certification_date": "2021-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "131883",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "WI",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tshimek289273@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "835 S Van Buren St",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543013526",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.