Individual provider Active NPI

Matthew Jewett, CRNA

  • Certified Registered Nurse Anesthetist
  • Fairmont, MN
National Provider Identifier
1174866446
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
252 Issued in MN
Practice address
800 Medical Center Dr
Fairmont, MN 56031-4575
Phone
(507) 238-8100
NPI assigned
Apr 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 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 252 MN Primary
Certified Registered Nurse Anesthetist 367500000X R 211725-0 MN

Addresses

Primary practice location

800 Medical Center Dr
Fairmont, MN 56031-4575

Mailing address

800 Medical Center Dr
Fairmont, MN 56031-4575
Phone (507) 238-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130503000269 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103063474 Reassigns benefits to 1 organization
I20220701001007 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103063474 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sioux Center HealthGroup PAC ID 9032027495, shared by 6 NPIs, 36 clinicians

Practice addresses (Care Compare)

1101 9TH St SE
Sioux Center, IA 51250-2501
Phone (712) 722-1271

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
252MNMDCertified Registered Nurse Anesthetist
R 211725-0MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sioux Center Health Current Accepting new patients
Sioux Center Health CurrentSince Apr 1, 2022 Accepting new patients
Floyd Valley Healthcare CurrentSince Sep 7, 2022 Accepting new patients
Sioux Center Health CurrentSince Apr 1, 2022 Accepting new patients
Mayo Clinic Health System-St James CurrentSince Apr 22, 2013 Accepting new patients
Floyd Valley Healthcare CurrentSince Sep 7, 2022 Accepting new patients

Locations

714 Lincoln St NE
Le Mars, IA 51031
Phone (712) 546-3338

1101 9th St SE
Sioux Center, IA 51250
Phone (712) 722-1271

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261

Organizations & group practices 6

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 1

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": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1174866446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314575",
            "telephone_number": "507-238-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314575",
            "telephone_number": "507-238-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWETT",
        "first_name": "MATTHEW",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "252",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 211725-0",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.