Individual provider Active NPI

Pamela E. Wagner, CRNA

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
National Provider Identifier
1104880418
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R 129882-4 Issued in MN
Practice address
800 E 28TH St
Minneapolis, MN 55407-3723
Phone
(612) 871-7639
Fax
(612) 872-0302
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 R 129882-4 MN Primary

Addresses

Primary practice location

800 E 28TH St
Minneapolis, MN 55407-3723

Mailing address

2545 Chicago Ave
Suite 311
Minneapolis, MN 55404-4522

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041223000054 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012975915 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Twin Cities Anesthesia Associates PCGroup PAC ID 9133491194, 72 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

155 Radio Dr
Woodbury, MN 55125-2619
Phone (952) 831-8742

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (651) 262-7633

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 129882-4MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jan 27, 2025 Accepting new patients
Tria Orthopaedic Center LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 16, 2023 Accepting new patients
Certified Anesthesia Care, Co. Nurse Anesthetist, Certified Registered CurrentSince Jul 3, 2019 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Feb 3, 2020 Accepting new patients
Allina Health System CurrentSince Jan 27, 2025 Accepting new patients
Allina Health System Current Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Jan 16, 2023 Accepting new patients
Twin Cities Anesthesia Associates PC Nurse Anesthetist, Certified Registered CurrentSince May 16, 2023 Accepting new patients
American Anesthesiology of Minnesota, P.a. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

9801 DuPont Ave S
Ste 100
Bloomington, MN 55431

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

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

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

8100 W 78th St
Ste 220
Minneapolis, MN 55439
Phone (952) 914-8400

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

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

10709 Wayzata Blvd
Ste 100
Minnetonka, MN 55305
Phone (763) 553-1142

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

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

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

400 10th St E
Waconia, MN 55387

155 Radio Dr
Woodbury, MN 55125
Phone (952) 883-6212

7125 Tamarack Rd
Ste 200
Woodbury, MN 55125
Phone (651) 748-4444

Organizations & group practices 9

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104880418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 CHICAGO AVE",
            "address_2": "SUITE 311",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-871-7639",
            "fax_number": "612-872-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "PAMELA",
        "middle_name": "E.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 129882-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.