Modern Therapeutics PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

MODERN THERAPEUTICS PLLC

Doing business as

Modern Therapeutics

Practice address

502 Division St S
Northfield, MN 55057-2020

Phone

(612) 488-2248

Fax

(612) 488-2248

NPI assigned

Dec 30, 2024

Organization subpart

No

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

Authorized official

Name

Andrea Berube, CRNANPI 1205223989

Title

Owner

Phone

(612) 616-7731

Specialties & licenses 2

Addresses

Other names 1

• Modern Therapeutics Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Andrea Berube

  • Adult Health Nurse Practitioner
  • Northfield, MN
  • NPI 1205223989
  NPD Authorized official
• Kelly Rogers, CRNA

  • Certified Registered Nurse Anesthetist
  • New Prague, MN
  • NPI 1104432079
  NPD

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786924800000",
    "number": "1356159891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 DIVISION ST S",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572020",
            "telephone_number": "612-488-2248",
            "fax_number": "612-488-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 DIVISION ST S",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572020",
            "telephone_number": "612-488-2248",
            "fax_number": "612-488-2248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Schilling Dr S",
            "address_purpose": "LOCATION",
            "city": "Dundas",
            "state": "MN",
            "postal_code": "550194075",
            "country_code": "US",
            "telephone_number": "612-488-2248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MODERN THERAPEUTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-30",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A",
        "authorized_official_last_name": "BERUBE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-616-7731",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modern Therapeutics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Modern Therapeutics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Anesthesiology Physician in Northfield, MN
• Providers in Northfield, MN by specialty
• Anesthesiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.