Individual provider Active NPI

Michael D Vad, CRNA

  • Certified Registered Nurse Anesthetist
  • New Richmond, WI
National Provider Identifier
1215028170
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
76740 Issued in MN
Practice address
130 S Knowles Ave
New Richmond, WI 54017-1727
Phone
(715) 246-3018
Fax
(715) 246-3019
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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-158100-7 MN
Certified Registered Nurse Anesthetist 367500000X 76740 MN Primary

Addresses

Primary practice location

130 S Knowles Ave
New Richmond, WI 54017-1727

Mailing address

130 S Knowles Ave
PO Box 118
New Richmond, WI 54017-0118
Phone (715) 246-3018

Other practice location 1

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3152

Other identifiers 2

IdentifierTypeStateIssuer
097N8VAOtherMNBLUE CROSS BLUE SHIELD
929483000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070714000148 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385744796 Reassigns benefits to 4 organizations
I20071024000618 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385744796 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians
St. Croix Regional Medical CenterGroup PAC ID 9335032184, 131 clinicians
Ladd Memorial HospitalGroup PAC ID 9931092848, 69 clinicians
Amery Regional Medical Center IncGroup PAC ID 2769391960, 124 clinicians

Practice addresses (Care Compare)

11855 Ulysses St NE
Blaine, MN 55434-7345
Phone (763) 755-6540

235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221

2600 65TH Ave
Osceola, WI 54020-4370
Phone (715) 294-2111

265 Griffin St E
Amery, WI 54001-1439
Phone (715) 268-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76740MNMDCertified Registered Nurse Anesthetist
R-158100-7MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Amery Regional Medical Center, Inc. Current Accepting new patients
Hudson Hospital, Inc. CurrentSince May 23, 2019 Accepting new patients
Baldwin Area Medical Center, Inc. CurrentSince Oct 28, 2015 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Jan 1, 2007 Accepting new patients
Westfields Hospital, Inc CurrentSince Nov 1, 2015 Accepting new patients
Ladd Memorial Hospital CurrentSince Jan 1, 2018 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Dec 1, 2015 Accepting new patients
North Metro Anesthesia Services P.a. Nurse Anesthetist, Certified Registered CurrentSince Nov 6, 2014 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Dec 6, 2025 Accepting new patients
Hudson Hospital, Inc. CurrentSince May 23, 2019 Accepting new patients
Ladd Memorial Hospital CurrentSince Jan 1, 2018 Accepting new patients
Certified Anesthesia Care, Co. Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2025 Accepting new patients
Baldwin Area Medical Center Inc. CurrentSince Oct 28, 2015 Accepting new patients
Westfields Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2015 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Jan 1, 2007 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Dec 1, 2015 Accepting new patients
River Valley Anesthesia, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

9801 DuPont Ave S
Ste 100
Bloomington, MN 55431

13601 80th Cir N
Ste 100
Maple Grove, MN 55369
Phone (612) 219-5355

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

701 Park Ave
#P4
Minneapolis, MN 55415
Phone (612) 873-2718

400 10th St E
Waconia, MN 55387

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301

1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

2600 65th Ave
Osceola, WI 54020
Phone (705) 268-8000

235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 6

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1215028170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S KNOWLES AVE",
            "address_2": "PO BOX 118",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540170118",
            "telephone_number": "715-246-3018",
            "fax_number": "715-246-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S KNOWLES AVE",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540171727",
            "telephone_number": "715-246-3018",
            "fax_number": "715-246-3019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-3152",
            "fax_number": "612-904-4218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAD",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R-158100-7",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "76740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "097N8VA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "929483000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Richmond, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.