Individual provider Active NPI

Kathleen Erin O'Meara, CRNA

  • Certified Registered Nurse Anesthetist
  • St. Paul, MN
National Provider Identifier
1154630259
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
085079 Issued in MN
Practice address
640 Jackson St
St. Paul, MN 55101
Phone
(651) 254-3456
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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 085079 MN Primary

Addresses

Primary practice location

640 Jackson St
St. Paul, MN 55101

Mailing address

1552 30TH St
Houlton, WI 54082-2124
Phone (715) 549-9123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110201000927 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608056007 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Twin Cities Anesthesia Associates PCGroup PAC ID 9133491194, 72 clinicians

Practice addresses (Care Compare)

927 Churchhill St W
Stillwater, MN 55082-6605
Phone (651) 439-5330

Hospital & facility affiliations

  • Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085079MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Cities Anesthesia Associates PC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2021 Accepting new patients
Regions Hospital CurrentSince Sep 26, 2010 Accepting new patients
Regions Hospital CurrentSince Sep 26, 2010 Accepting new patients

Locations

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

Organizations & group practices 3

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.

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": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1154630259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 30TH ST",
            "city": "HOULTON",
            "state": "WI",
            "postal_code": "540822124",
            "telephone_number": "715-549-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55101",
            "telephone_number": "651-254-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MEARA",
        "first_name": "KATHLEEN",
        "middle_name": "ERIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "085079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.