Individual provider Active NPI

Heather Marcella, CRNA

  • Certified Registered Nurse Anesthetist
  • Fargo, ND
National Provider Identifier
1174930309
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R33304 Issued in ND
Practice address
1720 University Dr S RT 1707
Fargo, ND 58103-6104
Phone
(701) 234-1728
Fax
(701) 234-1681
NPI assigned
Jul 21, 2014
Last updated
Jul 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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 193968-8 MN
Certified Registered Nurse Anesthetist 367500000X R33304 ND Primary

Addresses

Primary practice location

1720 University Dr S RT 1707
Fargo, ND 58103-6104

Mailing address

1720 University Dr S RT 1707
Fargo, ND 58103-6104
Phone (701) 234-1728

Other practice location 1

2301 25th St S Ste K
Fargo, ND 58103-6104
Phone (701) 234-1728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141208001635 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355663022 Reassigns benefits to 2 organizations
I20160128002551 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355663022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians
University Anesthesia Providers LLCGroup PAC ID 7315986064, 325 clinicians

Practice addresses (Care Compare)

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7000

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-4097

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
551MNMDNurse Practitioner
R 193968-8MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Plains Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2017 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jan 11, 2016 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jan 11, 2016 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2023 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
Valley Anesthesia Associates PC Nurse Anesthetist, Certified Registered PastSince Jul 1, 1997 Accepting new patients

Locations

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

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

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

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

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1720 University Dr S
#1707
Fargo, ND 58103
Phone (701) 234-1728

2301 25th St S
Ste K
Fargo, ND 58103
Phone (701) 234-1728

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

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, 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": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1174930309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 UNIVERSITY DR S RT 1707",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036104",
            "telephone_number": "701-234-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 UNIVERSITY DR S RT 1707",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036104",
            "telephone_number": "701-234-1728",
            "fax_number": "701-234-1681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 25th St S Ste K",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581036104",
            "country_code": "US",
            "telephone_number": "701-234-1728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCELLA",
        "first_name": "HEATHER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 193968-8",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R33304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.