NPIMap

Organization Active NPI

Twin Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Blaine, MN
National Provider Identifier
1265105332
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
TWIN ANESTHESIA LLC
Practice address
2622 132ND Ave NE
Blaine, MN 55449-0047
Phone
(715) 410-8742
NPI assigned
Jul 26, 2021
Last updated
Jul 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Mr. Andrew Paul Dickman, CRNA, APRNNPI 1831618859
Title
Ceo, Co-Owner
Phone
(715) 410-8742

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2622 132ND Ave NE
Blaine, MN 55449-0047

Mailing address

2622 132ND Ave NE
Blaine, MN 55449-0047
Phone (715) 410-8742

Other identifiers 2

IdentifierTypeStateIssuer
1831618859MedicaidMN
1407375967MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230523003183 WI Part B Supplier - Clinic/Group Practice 2163888793 Receives reassigned benefits from 20 practitioners
Practice locations: Hudson, WI
O20240816002642 MN Part B Supplier - Clinic/Group Practice 2163888793 Receives reassigned benefits from 29 practitioners
Practice locations: Lake Elmo, MN; Saint Paul, MN

National Provider Directory

National Provider Directory
Tax ID family
Twin Anesthesia LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1265105332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2622 132ND AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554490047",
            "telephone_number": "715-410-8742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 132ND AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554490047",
            "telephone_number": "715-410-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "DICKMAN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CEO, CO-OWNER",
        "authorized_official_telephone_number": "715-410-8742",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA, APRN"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831618859",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407375967",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.