Individual provider Active NPI

Melissa Ann Mogen, CRNA

  • Certified Registered Nurse Anesthetist
  • Cottage Grove, MN
National Provider Identifier
1225929672
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3228 Issued in MN
Practice address
7686 Homestead Ave S
Cottage Grove, MN 55016-1989
Phone
(716) 208-8778
NPI assigned
Jul 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2251886 MN
Certified Registered Nurse Anesthetist 367500000X 3228 MN Primary

Addresses

Primary practice location

7686 Homestead Ave S
Cottage Grove, MN 55016-1989

Mailing address

7686 Homestead Ave S
Cottage Grove, MN 55016-1989
Phone (716) 208-8778

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251106003346 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567952708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
North Metro Anesthesia Services PAGroup PAC ID 0648244152, 16 clinicians

Practice addresses (Care Compare)

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 464-4611

Hospital & facility affiliations

  • Fairview Lakes Health Services Hospital, Wyoming, MN, CCN 240050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2251886MNMDRegistered Nurse
3228MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North Metro Anesthesia Services P.a. Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2025 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

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

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1225929672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7686 HOMESTEAD AVE S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550161989",
            "telephone_number": "716-208-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7686 HOMESTEAD AVE S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550161989",
            "telephone_number": "716-208-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGEN",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2251886",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "3228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.