NPIMap

Individual provider Active NPI

Sean C Sundermann, CRNA

  • Certified Registered Nurse Anesthetist
  • Sioux Falls, SD
National Provider Identifier
1952577074
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
SD-CRNA CR000696 Issued in SD
Practice address
800 E 21St St
Sioux Falls, SD 57105-1016
Phone
(605) 322-2754
Fax
(605) 322-2727
NPI assigned
May 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X SD-CRNA CR000696 SD Primary

Addresses

Primary practice location

800 E 21St St
Sioux Falls, SD 57105-1016

Mailing address

PO Box 5045
Attn: P.F.S.
Sioux Falls, SD 57117-5045
Phone (605) 322-2754

Other identifiers 5

IdentifierTypeStateIssuer
46022474348MedicaidNE
9261973OtherDAKOTACARE
5755890MedicaidSD
1952577074MedicaidIA
P00892216OtherSDRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080603000852 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163592015 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians
City of BrookingsGroup PAC ID 1052307105, 112 clinicians

Practice addresses (Care Compare)

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

300 22ND Ave
Brookings, SD 57006-2480
Phone (605) 692-6351

909 N Iowa Ave
Dell Rapids, SD 57022-1231
Phone (605) 428-5431

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SD-CRNA CR000696SDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St Marys Nurse Anesthetist, Certified Registered CurrentSince Nov 10, 2018 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Nurse Anesthetist, Certified Registered CurrentSince Apr 17, 2008 Accepting new patients
Avera McKennan CurrentSince Apr 17, 2008 Accepting new patients
City of Brookings CurrentSince May 12, 2021 Accepting new patients
Avera St Marys CurrentSince Nov 10, 2018 Accepting new patients

Locations

300 22nd Ave
Brookings, SD 57006
Phone (605) 692-6351

909 N Iowa Ave
Dell Rapids, SD 57022
Phone (605) 428-5431

800 E 21st St
Sioux Falls, SD 57105
Phone (605) 322-2754

Interoperability endpoints

  • Direct secure messaging: ssundermann891292@direct.centracare.com

Organizations & group practices 6

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 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1952577074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5045",
            "address_2": "ATTN: P.F.S.",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175045",
            "telephone_number": "605-322-2754",
            "fax_number": "605-322-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 21ST ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051016",
            "telephone_number": "605-322-2754",
            "fax_number": "605-322-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERMANN",
        "first_name": "SEAN",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-08",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "SD-CRNA CR000696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46022474348",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9261973",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5755890",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952577074",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00892216",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.