Individual provider Active NPI

Heidi Genereux, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Breckenridge, MN
National Provider Identifier
1124135629
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R 095825 9 Issued in MN
Practice address
2400 St Francis Dr
Breckenridge, MN 56520-1025
Phone
(218) 643-3000
Fax
(574) 268-0684
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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 R 095825 9 MN Primary
Certified Registered Nurse Anesthetist 367500000X R20219 ND

Addresses

Primary practice location

2400 St Francis Dr
Breckenridge, MN 56520-1025

Mailing address

PO Box 1296
Warsaw, IN 46581-1296
Phone (574) 268-9640

Other identifiers 4

IdentifierTypeStateIssuer
430051818OtherMNPALMETTO GBA - RAILROAD MEDICARE
12110MedicaidND
149842800MedicaidMN
430051818OtherNDPALMETTA GBA - RAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100512000108 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466365192 Reassigns benefits to 1 organization
I20101118000325 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466365192 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis Medical CenterGroup PAC ID 8123937992, shared by 4 NPIs, 16 clinicians

Practice addresses (Care Compare)

2400 St Francis Dr
Breckenridge, MN 56520-1025
Phone (218) 643-3000

Merit-based Incentive Payment System (MIPS)

Final score
1.88 of 100Reported as group
Quality
0
Improvement activities
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1199MNMDRegistered Dietitian
R 095825 9MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Valley City CurrentSince Mar 31, 2016 Accepting new patients
St. Francis Medical Center CurrentSince Feb 1, 2016 Accepting new patients
Mercy Hospital of Valley City Current Accepting new patients
Mercy Hospital CurrentSince Mar 31, 2016 Accepting new patients
St. Francis Medical Center CurrentSince Dec 31, 2025 Accepting new patients
Lisbon Area Health Services Past Accepting new patients
St Francis Medical Center Past Accepting new patients

Locations

3293 Solutions Ctr
Chicago, IL 60677

3265 Solutions Ctr
Chicago, IL 60677

2400 St Francis Dr
Breckenridge, MN 56520
Phone (218) 643-0226

570 Chautauqua Blvd
Valley City, ND 58072
Phone (701) 845-0440

Organizations & group practices 7

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1124135629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1296",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465811296",
            "telephone_number": "574-268-9640",
            "fax_number": "574-268-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ST FRANCIS DR",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565201025",
            "telephone_number": "218-643-3000",
            "fax_number": "574-268-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENEREUX",
        "first_name": "HEIDI",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 095825 9",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R20219",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD MEDICARE",
            "identifier": "430051818",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12110",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149842800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTA GBA - RAILROAD MEDICARE",
            "identifier": "430051818",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Breckenridge, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.