Traci Lynn Pantzke, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R22825 Issued in ND

Practice address

2301 25TH St S
Ste K
Fargo, ND 58103-6104

Phone

(701) 234-1728

Fax

(701) 234-1628

NPI assigned

May 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Traci Lynn Olson Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

University of North Dakota School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascend Anesthesia LLCGroup PAC ID 5294246526, 76 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Ascend Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Mesa, AZ
  • NPI 1407642945

  AZ, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Dec Anesthesia LLC

  • Anesthesiology Physician
  • Mesa, AZ
  • NPI 1093006520

  AZ

  Medicare reassignment NPD
• Summit Anesthesia Services PLLC

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
  • NPI 1821589144

  AZ, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Westside Anesthesia Services PLC

  • Anesthesiology Physician
  • Glendale, AZ
  • NPI 1831408038

  AZ

  Medicare reassignment NPD
• St Francis Medical Center

  • Rural Health Clinic/Center
  • Milnor, ND
  • NPI 1235215252
  NPD (past)
• Mesa Az Endoscopy ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1770557233
  NPD (past)
• Pinnacle Global Health LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Phoenix, AZ
  • NPI 1114832417
  NPD (past)
• Red River Anesthesia P C

  • Certified Registered Nurse Anesthetist
  • Breckenridge, MN
  • NPI 1295842623

  Nurse Anesthetist, Certified Registered

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1932159183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 25TH ST S",
            "address_2": "STE K",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036104",
            "telephone_number": "701-234-1728",
            "fax_number": "701-234-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 25TH ST S",
            "address_2": "STE K",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036104",
            "telephone_number": "701-234-1728",
            "fax_number": "701-234-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTZKE",
        "first_name": "TRACI",
        "middle_name": "LYNN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R22825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BLUE SHIELD",
            "identifier": "020823",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BLUE SHIELD",
            "identifier": "131R8PA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10221",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "OLSON",
            "middle_name": "LYNN",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Colette Pameijer, M.D.
• Caitlin L. Pandolfo, M.D.
• Sarah Francine Pangelinan, LCSW
• Chelsa Lyn Pansch, LMSW
• Lydia Pansegrau
• Amit Panwalkar
• Paracelsus Healthcare Corp
• Andrea Paradis, LMSW
• Margaret Awoellen Parakoyi
• Sejal Parikh, MD

• All providers in Fargo, ND
• Certified Registered Nurse Anesthetist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.