Individual provider Active NPI

Dillon Joseph Dryja, CRNA

  • Certified Registered Nurse Anesthetist
  • Plymouth, MN
National Provider Identifier
1073013462
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2185 Issued in MN
Practice address
14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876
Phone
(763) 852-0411
NPI assigned
Feb 13, 2018
Last updated
Feb 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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 2185 MN Primary

Addresses

Primary practice location

14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876

Mailing address

3118 W Lake St Unit 508
Minneapolis, MN 55416-6814
Phone (920) 539-2568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180518000726 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688939861 Reassigns benefits to 2 organizations
I20230605001710 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688939861 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Jan 17, 2018 Accepting new patients

Locations

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

310 Smith Ave N
Ste 100
Saint Paul, MN 55102
Phone (651) 251-5500

400 10th St E
Waconia, MN 55387

2651 Hillcrest Dr
Hudson, WI 54016
Phone (630) 632-2648

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1073013462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3118 W LAKE ST UNIT 508",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554166814",
            "telephone_number": "920-539-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 28TH AVE N STE 20",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474876",
            "telephone_number": "763-852-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRYJA",
        "first_name": "DILLON",
        "middle_name": "JOSEPH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "2185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.