Individual provider Active NPI

Samantha Greensky Pykkonen, CRNA

  • Certified Registered Nurse Anesthetist
  • Duluth, MN
National Provider Identifier
1093969453
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1011 Issued in MN
Practice address
915 E 1St St
Duluth, MN 55805-2107
Phone
(218) 249-5555
NPI assigned
Nov 12, 2008
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R144371-8 MN
Certified Registered Nurse Anesthetist 367500000X 1011 MN Primary

Addresses

Primary practice location

915 E 1St St
Duluth, MN 55805-2107

Mailing address

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI, ND, ID4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20090203000410 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618031899 Reassigns benefits to 8 organizations
I20240201004025 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618031899 Reassigns benefits to 1 organization
I20260317004553 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618031899 Reassigns benefits to 2 organizations
I20260430004436 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618031899 Reassigns benefits to 2 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

Practice addresses (Care Compare)

2422 20TH St SW
Jamestown, ND 58401-6201

6640 Kaniksu St
Bonners Ferry, ID 83805-7532

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1011MNMDMarriage & Family Therapist
R144371-8MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Hospital Association CurrentSince Dec 1, 2022 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Nov 3, 2008 Accepting new patients
Lutheran Charity Association CurrentSince Mar 1, 2026 Accepting new patients
Lakewood Health System CurrentSince Dec 13, 2024 Accepting new patients
Memorial Medical Center Inc CurrentSince Dec 3, 2023 Accepting new patients
Cook County Hospital District CurrentSince Nov 6, 2025 Accepting new patients
Lutheran Charity Association CurrentSince Mar 1, 2026 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Dec 26, 2023 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Nov 3, 2008 Accepting new patients
Lutheran Charity Association CurrentSince Mar 1, 2026 Accepting new patients
Memorial Medical Center Inc CurrentSince Dec 3, 2023 Accepting new patients
Lakewood Health System CurrentSince Dec 13, 2024 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
North Shore Anesthesia P.a Nurse Anesthetist, Certified Registered CurrentSince Apr 29, 2021 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

512 Skyline Blvd
Cloquet, MN 55720
Phone (218) 878-7207

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

1420 London Rd
Ste 100
Duluth, MN 55805
Phone (218) 728-0650

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

515 5th Ave W
Grand Marais, MN 55604
Phone (218) 387-3040

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

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

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

49725 County 83
Staples, MN 56479
Phone (218) 894-1033

2422 20th St SW
Jamestown, ND 58401
Phone (701) 252-1050

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1093969453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "218-249-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "218-249-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYKKONEN",
        "first_name": "SAMANTHA",
        "middle_name": "GREENSKY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-12",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R144371-8",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "1011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.