Individual provider Active NPI

Angela Marie Wiski, CRNA

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
National Provider Identifier
1235237371
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1471926 Issued in MN
Practice address
2828 Chicago Ave
Minneapolis, MN 55407-1544
Phone
(612) 871-7639
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R1471926 MN Primary

Addresses

Primary practice location

2828 Chicago Ave
Minneapolis, MN 55407-1544

Mailing address

18201 Jaguar Path
Lakeville, MN 55044-6405
Phone (651) 335-2139

Other identifiers 2

IdentifierTypeStateIssuer
645265500MedicaidMN
96G44SEOtherMNBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060303000122 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981610771 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians
Mngi Digestive Health PAGroup PAC ID 8123016557, 276 clinicians

Practice addresses (Care Compare)

2620 Eagan Woods Dr
Suite 300
Eagan, MN 55121-1138
Phone (651) 968-5215

3001 Broadway St NE
Suite 500
Minneapolis, MN 55413-2197
Phone (612) 871-1145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1471926MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2023 Accepting new patients
Mngi Digestive Health, P.a. CurrentSince Apr 2, 2018 Accepting new patients
Northwest Anesthesia, P.a. Past Accepting new patients
Northwest Anesthesia P.a. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

5705 W Old Shakopee Rd
Ste 150
Bloomington, MN 55437
Phone (612) 870-5530

1185 Town Centre Dr
Ste 205
Eagan, MN 55123

2620 Eagan Woods Dr
Ste 300
Eagan, MN 55121
Phone (651) 968-5215

8100 W 78th St
Ste 220
Minneapolis, MN 55439
Phone (952) 914-8400

3001 Broadway St NE
Ste 500
Minneapolis, MN 55413
Phone (612) 870-5557

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

2020 E 28th St
Ste 100
Minneapolis, MN 55407
Phone (612) 455-0612

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

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

2080 Woodwinds Dr
Ste 200
Woodbury, MN 55125
Phone (651) 642-1106

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1235237371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18201 JAGUAR PATH",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446405",
            "telephone_number": "651-335-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071544",
            "telephone_number": "612-871-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISKI",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1471926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "645265500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "96G44SE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; 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.