Individual provider Active NPI

Gary K Cozine, CRNA

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
National Provider Identifier
1174597363
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1877 Issued in MN
Practice address
800 E 28TH St
Minneapolis, MN 55407
Phone
(865) 342-8900
Fax
(865) 691-0843
NPI assigned
Feb 14, 2006
Last updated
Jun 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 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 1877 MN Primary

Addresses

Primary practice location

800 E 28TH St
Minneapolis, MN 55407

Mailing address

2854 Highway 55
Suite 130
Eagan, MN 55121
Phone (651) 842-3344

Other practice location 1

393 Dunlap St
St Paul, MN 55104
Phone (651) 602-7245

Other practice location 2

9645 Grove Cir N Ste 250
Maple Grove, MN 55369-4466
Phone (763) 201-8191

Other identifiers 1

IdentifierTypeStateIssuer
784242200MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031120000485 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183528391 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates, PLLCGroup PAC ID 4284879701, 6 clinicians

Practice addresses (Care Compare)

3000 Hundertmark Rd
Suite 200
Chaska, MN 55318-1152
Phone (763) 201-8191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42992MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates, PLLC CurrentSince Jul 1, 2017 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2016 Accepting new patients
Certified Anesthesia Care, Co. Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2023 Accepting new patients
Laboratory Corportation of America Holdings Past Accepting new patients
Regina Medical Center Past Accepting new patients
Interventional Spine and Pain Physicians, PA PastSince Aug 1, 2024 Accepting new patients
Racine Anesthesia Services, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

11091 Ulysses St NE
Ste 400
Blaine, MN 55434
Phone (763) 421-9410

9801 DuPont Ave S
Ste 100
Bloomington, MN 55431

14000 Nicollet Ave
Ste 104
Burnsville, MN 55337

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

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

3000 Hundertmark Rd
Ste 200
Chaska, MN 55318
Phone (952) 479-6304

7700 France Ave S
Ste 260
Edina, MN 55435

1175 Nininger Rd
Hastings, MN 55033
Phone (651) 404-1000

9600 Upland Ln N
Ste 160
Maple Grove, MN 55369

9645 Grove Cir N
Ste 250
Maple Grove, MN 55369

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

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

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

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

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

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

400 10th St E
Waconia, MN 55387

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1174597363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2854 HIGHWAY 55",
            "address_2": "SUITE 130",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "55121",
            "telephone_number": "651-842-3344",
            "fax_number": "651-842-3391"
        },
        {
            "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": "55407",
            "telephone_number": "865-342-8900",
            "fax_number": "865-691-0843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "393 Dunlap St",
            "address_purpose": "LOCATION",
            "city": "St Paul",
            "state": "MN",
            "postal_code": "55104",
            "country_code": "US",
            "telephone_number": "651-602-7245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9645 Grove Cir N Ste 250",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553694466",
            "country_code": "US",
            "telephone_number": "763-201-8191",
            "fax_number": "763-201-8192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COZINE",
        "first_name": "GARY",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "1877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "784242200",
            "state": "MN"
        }
    ],
    "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 Jun 13, 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.