Individual provider Active NPI

William Matthew Nettekoven, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Paul, MN
National Provider Identifier
1225545262
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
114118-23 Issued in NH
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-3456
NPI assigned
Dec 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 211715-3 MN
Certified Registered Nurse Anesthetist 367500000X 114118-23 NH Primary
Certified Registered Nurse Anesthetist 367500000X 222424 WI

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

1305 140TH Ave
New Richmond, WI 54017-6613
Phone (952) 836-9582

Other practice location 1

5 Alumni Dr
Exeter, NH 03833-2160
Phone (603) 778-7311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI, NH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180226001006 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365703873 Reassigns benefits to 4 organizations
I20210401000637 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365703873 Reassigns benefits to 8 organizations
I20250509000538 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365703873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, 797 clinicians
Anesthesiology, P.a.Group PAC ID 9335033034, 136 clinicians

Practice addresses (Care Compare)

1221 Whipple St
Eau Claire, WI 54703-5270
Phone (715) 838-3806

3300 N Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-5370

733 W Clairemont Ave
Eau Claire, WI 54701-6101
Phone (715) 838-5222

Hospital & facility affiliations

  • Mayo Clinic Health System Eau Claire Hospital Hospital, Eau Claire, WI, CCN 520070
  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
211715-3MNMDCertified Registered Nurse Anesthetist
114118-23NHMDCertified Registered Nurse Anesthetist
222424WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology, P.a. Nurse Anesthetist, Certified Registered CurrentSince Jul 22, 2025 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Feb 23, 2021 Accepting new patients
Westfields Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince Dec 28, 2025 Accepting new patients
Hudson Hospital, Inc. CurrentSince Dec 13, 2025 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Dec 6, 2025 Accepting new patients
Westfields Hospital, Inc CurrentSince Dec 28, 2025 Accepting new patients
Anesthesia Care Group PC CurrentSince May 2, 2025 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Baldwin Area Medical Center, Inc. CurrentSince Feb 1, 2024 Accepting new patients
Hudson Hospital, Inc. CurrentSince Dec 13, 2025 Accepting new patients
Ladd Memorial Hospital CurrentSince Feb 1, 2024 Accepting new patients
Ladd Memorial Hospital CurrentSince Feb 1, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Feb 23, 2021 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 28, 2020 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Dec 6, 2025 Accepting new patients
Baldwin Area Medical Center Inc. CurrentSince Feb 1, 2024 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2019 Accepting new patients
Regions Hospital CurrentSince Dec 16, 2023 Accepting new patients

Locations

9855 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-5800

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

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

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

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

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

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

5 Alumni Dr
Exeter, NH 03833
Phone (603) 580-6339

88 McGregor St
Ste 303
Manchester, NH 03102
Phone (603) 647-9325

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

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

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

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

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

Organizations & group practices 20

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 20

Hospital & facility affiliations 5

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": "1514505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1225545262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 140TH AVE",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540176613",
            "telephone_number": "952-836-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Alumni Dr",
            "address_purpose": "LOCATION",
            "city": "Exeter",
            "state": "NH",
            "postal_code": "038332160",
            "country_code": "US",
            "telephone_number": "603-778-7311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NETTEKOVEN",
        "first_name": "WILLIAM",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-29",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "211715-3",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "114118-23",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "222424",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.