Individual provider Active NPI

Christian T Cavalier, CRNA

  • Certified Registered Nurse Anesthetist
  • Ely, MN
National Provider Identifier
1316948813
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1464315 Issued in MN
Practice address
2760 Bear Island River Rd
Ely, MN 55731-8310
Phone
(218) 820-7119
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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 R1464315 MN Primary

Addresses

Primary practice location

2760 Bear Island River Rd
Ely, MN 55731-8310

Mailing address

2760 Bear Island River Rd
Ely, MN 55731-8310
Phone (218) 820-7119

Other identifiers 1

IdentifierTypeStateIssuer
372163900MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050112000416 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325096787 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ely-Bloomenson Community Hospital 2 clinicians

Practice addresses (Care Compare)

328 W Conan St
Ely, MN 55731-1145
Phone (218) 365-3271

Hospital & facility affiliations

  • Ely - Bloomenson Community Hospital Hospital, Ely, MN, CCN 241318

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Range Regional Health Services CurrentSince Jan 1, 2017 Accepting new patients
Range Regional Health Services CurrentSince Jan 1, 2017 Accepting new patients
Northern Itasca Hospital District Past Accepting new patients
Range Regional Health Services Past Accepting new patients

Locations

3605 Mayfair Ave
Hibbing, MN 55746
Phone (218) 262-3441

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1316948813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 BEAR ISLAND RIVER RD",
            "city": "ELY",
            "state": "MN",
            "postal_code": "557318310",
            "telephone_number": "218-820-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 BEAR ISLAND RIVER RD",
            "city": "ELY",
            "state": "MN",
            "postal_code": "557318310",
            "telephone_number": "218-820-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALIER",
        "first_name": "CHRISTIAN",
        "middle_name": "T",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1464315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372163900",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "2760 Bear Island River Rd",
            "city": "Ely",
            "state": "MN",
            "country_code": "US",
            "postal_code": "557318310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ely, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.