Individual provider Active NPI

Frank A Jirik

  • Certified Registered Nurse Anesthetist
  • St Louis Park, MN
National Provider Identifier
1073707246
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1529179 Issued in MN
Practice address
6500 Excelsior Blvd
St Louis Park, MN 55426
Phone
(952) 993-5000
NPI assigned
Aug 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 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 R1529179 MN Primary

Addresses

Primary practice location

6500 Excelsior Blvd
St Louis Park, MN 55426

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

Other practice location 2

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080325000259 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527144047 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis Ambulatory Services LLCGroup PAC ID 2466986922, 24 clinicians
Park Nicollet Methodist HospitalGroup PAC ID 7315840063, 112 clinicians

Practice addresses (Care Compare)

1700 St Francis Ave
Suite 100
Shakopee, MN 55379-5582
Phone (952) 993-7800

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1529179MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Methodist Hospital CurrentSince Nov 12, 2018 Accepting new patients
St Francis Ambulatory Services LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 4, 2024 Accepting new patients
Southdale Anesthesiologists, LLC CurrentSince May 1, 2018 Accepting new patients
Park Nicollet Methodist Hospital Nurse Anesthetist, Certified Registered CurrentSince Nov 12, 2018 Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

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

1700 Saint Francis Ave
Ste 100
Shakopee, MN 55379
Phone (952) 993-7800

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1073707246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "55426",
            "telephone_number": "952-993-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6401 France Ave S",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352104",
            "country_code": "US",
            "telephone_number": "952-924-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6401 France Ave S",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352104",
            "country_code": "US",
            "telephone_number": "952-924-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIRIK",
        "first_name": "FRANK",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-30",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1529179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.