TYLER DAVIS-SANDFOSS
NPI 1063981397
Nurse Anesthetist, Certified Registered in Chicago, IL

Q: What is Tyler Davis-sandfoss's NPI number?

The NPI number for Tyler Davis-sandfoss is 1063981397. It was assigned to this individual provider in the NPPES registry on November 15, 2018.

Q: What is Tyler Davis-sandfoss's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Active since November 15, 2018PECOS Enrolled

1969 W OGDEN AVE, CHICAGO, IL 60612(312) 864-0454 Get Directions Write a Review

NPPES record last updated: March 22, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 22, 2019, Nov 15, 2018 (2 updates tracked since 2018).

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About Tyler Davis-sandfoss NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYLER DAVIS-SANDFOSS (NPI 1063981397) is an individual nurse anesthetist, certified registered in Chicago, Illinois, licensed in Illinois (209018741) and active in the NPI registry since November 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063981397

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameTYLER DAVIS-SANDFOSS

Location Address1969 W OGDEN AVEChicago, IL 60612-3765

Mailing Address3218 N Clark St Apt 410Chicago, IL 60657-0021 · (859) 866-4479

Phone(312) 864-0454

Sole ProprietorNo

Enumeration DateNovember 15, 2018

Last NPPES UpdateMarch 22, 20192 updates tracked since enumeration

✔ NPI 1063981397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in IL · 209018741

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Also ListedRegistered Nurse · Critical Care MedicineTaxonomy 163WC0200X · License 041.471617 (IL)

1969 W OGDEN AVE, Chicago, IL 60612

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tyler Davis-sandfoss is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging– Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Tyler Davis-sandfoss reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lurie Children's Medical Group Inc

3.2 mi

Pediatrics

225 E CHICAGO AVE
Chicago, IL 60611

Reassigned Medicare billing, Illinois enrollment
826 clinicians in this Medicare group

NPI 1518064716 (312) 227-6412

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60612 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$138.86 typical visit price

range $60.08 – $183.39

Typical copayment $34.71 (range $15.02 – $45.84)

Most-billed visit code 99204

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. VIGNESH CHIDAMBARAM MD, MPH

Internal Medicine (Cardiovascular Disease)

1969 W OGDEN AVE
CHICAGO, IL 60612

Cook County (312) 864-6000

LUCAS KUZMANIC DO

Internal Medicine

1969 W OGDEN AVE
CHICAGO, IL 60612

Cook County (312) 864-6000

KEERTHIKA VIJAYAKUMAR MBBS

Internal Medicine

1969 W OGDEN AVE
CHICAGO, IL 60612

Cook County (312) 864-6000

NABEEL ZIA AHMED

Internal Medicine

1969 W OGDEN AVE
CHICAGO, IL 60612

Cook County (312) 864-6000

DR. VAMSI KRISHNA KAZA M.D., MBBS

Internal Medicine

1969 W OGDEN AVE
CHICAGO, IL 60612

Cook County (312) 864-6000

CHRISTINE MARIA WHIPPLE LCSW

Social Worker (Clinical)

1969 W OGDEN AVE, ROOM 1698
CHICAGO, IL 60612

Cook County (312) 864-1466

LESLIE FENIO PA-C

Physician Assistant

1969 W OGDEN AVE
CHICAGO, IL 60612

Cook County (312) 864-7761

DR. JACOB DUDZINSKI MD

Dermatology

1969 W OGDEN AVE
CHICAGO, IL 60612

Cook County (312) 864-6000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyler Davis-sandfoss's NPI number?

The NPI number for Tyler Davis-sandfoss is 1063981397. It was assigned to this individual provider in the NPPES registry on November 15, 2018.

Where is Tyler Davis-sandfoss located?

Tyler Davis-sandfoss practices at 1969 W Ogden Ave, Chicago, IL 60612. The listed phone number is (312) 864-0454.

What is Tyler Davis-sandfoss's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Tyler Davis-sandfoss enrolled in Medicare?

Yes. Tyler Davis-sandfoss is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tyler Davis-sandfoss's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tyler Davis-sandfoss reassigns Medicare benefits to Lurie Children's Medical Group Inc (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tyler Davis-sandfoss's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tyler Davis-sandfoss was last updated on March 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.