| Tyler Anthony Wolpert, | |
|
5300 N Meadows Dr, Grove City, OH 43123-2546 | |
| (614) 663-5000 | |
| Not Available |
| Full Name | Tyler Anthony Wolpert |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 5300 N Meadows Dr, Grove City, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144075375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | RN.435880 (Ohio) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | APRN.CRNA.0021069 (Ohio) | Primary |
| Entity Name | Premier Anesthesia Of Ohio Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699196022 PECOS PAC ID: 3779714258 Enrollment ID: O20140326001267 |
| Mailing Address | Practice Location Address |
|---|---|
| Tyler Anthony Wolpert, 196 S Grant Ave Apt 204, Columbus, OH 43215-8365 Ph: (740) 317-3230 | Tyler Anthony Wolpert, 5300 N Meadows Dr, Grove City, OH 43123-2546 Ph: (614) 663-5000 |
Clayton Roush, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2977 Orders Rd, Grove City, OH 43123 Phone: 304-593-8209 | |
Randall Kinietz, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 5300 N Meadows Dr, Grove City, OH 43123 Phone: 614-663-5000 | |
Jacob Deemer, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1649 Nature Dr, Grove City, OH 43123 Phone: 724-809-1042 |