Individual provider Active NPI

Erin Louise Fugleberg

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
National Provider Identifier
1265834535
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
104971 Issued in MN
Practice address
317 Groveland Ave Unit 312
Minneapolis, MN 55403-3661
Phone
(612) 615-5054
NPI assigned
Sep 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 189376-30 WI
Registered Nurse 163W00000X R-184126-8 MN
Certified Registered Nurse Anesthetist 367500000X 104971 MN Primary

Addresses

Primary practice location

317 Groveland Ave Unit 312
Minneapolis, MN 55403-3661

Mailing address

317 Groveland Ave Unit 312
Minneapolis, MN 55403-3661
Phone (612) 615-5054

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150217002126 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315262284 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mngi Digestive Health PAGroup PAC ID 8123016557, 276 clinicians

Practice addresses (Care Compare)

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
R-184126-8MNMDRegistered Nurse
189376-30WIMDRegistered Nurse
104971MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Cities Anesthesia Associates PC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2017 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2016 Accepting new patients
Mngi Digestive Health, P.a. CurrentSince Aug 20, 2018 Accepting new patients

Locations

1185 Town Centre Dr
Ste 205
Eagan, MN 55123

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

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

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

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

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

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

237 Radio Dr
Ste 200
Woodbury, MN 55125

Interoperability endpoints

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

Organizations & group practices 3

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": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1265834535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 GROVELAND AVE UNIT 312",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033661",
            "telephone_number": "612-615-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 GROVELAND AVE UNIT 312",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033661",
            "telephone_number": "612-615-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGLEBERG",
        "first_name": "ERIN",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "189376-30",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R-184126-8",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "104971",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 30, 2014; 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.