Individual provider Active NPI

Rachel K Deambrogio, CRNA

  • Certified Registered Nurse Anesthetist
  • Burnsville, MN
National Provider Identifier
1184358475
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2741 Issued in MN
Practice address
201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone
(952) 892-2000
Fax
(952) 442-3620
NPI assigned
Jul 12, 2022
Last updated
Jul 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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 2741 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

201 E Nicollet Blvd
Burnsville, MN 55337-5714

Mailing address

400 10TH St E
Waconia, MN 55387-4552
Phone (952) 442-9770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221201003304 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214305887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians
South Metropolitan Anesthesia PAGroup PAC ID 1153370911, 25 clinicians

Practice addresses (Care Compare)

14101 Fairview Dr
Suite 400
Burnsville, MN 55337-2539
Phone (952) 658-8000

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2741MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2024 Accepting new patients
South Metropolitan Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Oct 4, 2022 Accepting new patients

Locations

14101 Fairview Dr
Ste 400
Burnsville, MN 55337
Phone (952) 658-8000

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

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

400 10th St E
Waconia, MN 55387

Organizations & group practices 2

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.

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": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1184358475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 10TH ST E",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E NICOLLET BLVD",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553375714",
            "telephone_number": "952-892-2000",
            "fax_number": "952-442-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAMBROGIO",
        "first_name": "RACHEL",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "2741",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.