Individual provider Active NPI

Rory S Kortan, CRNA

  • Certified Registered Nurse Anesthetist
  • St Paul, MN
National Provider Identifier
1386653889
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1466326 Issued in MN
Practice address
640 Jackson Street
Mail Stop 11503P
St Paul, MN 55101-2502
Phone
(651) 254-3456
Fax
(651) 254-3048
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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 R1466326 MN Primary

Addresses

Primary practice location

640 Jackson Street
Mail Stop 11503P
St Paul, MN 55101-2502

Mailing address

8100 34TH Ave S
21110Q
Bloomington, MN 55425-1672
Phone (952) 883-5463

Other identifiers 2

IdentifierTypeStateIssuer
524161800MedicaidMN
68S33KOOtherMNBCBSMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060504000454 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800806845 Reassigns benefits to 5 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
South Metropolitan Anesthesia PAGroup PAC ID 1153370911, 25 clinicians
Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians

Practice addresses (Care Compare)

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 863-5370

Hospital & facility affiliations

  • M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1466326MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Certified Anesthesia Care, Co. Nurse Anesthetist, Certified Registered CurrentSince May 1, 2019 Accepting new patients
Southdale Anesthesiologists, LLC CurrentSince May 1, 2018 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2020 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Feb 8, 2020 Accepting new patients
South Metropolitan Anesthesia, PA Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2008 Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

9801 DuPont Ave S
Ste 100
Bloomington, MN 55431

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

14101 Fairview Dr
Burnsville, MN 55337
Phone (612) 672-5346

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

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

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

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

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

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

640 Jackson St
Stop 11503P
Saint Paul, MN 55101
Phone (651) 254-3456

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

400 10th St E
Waconia, MN 55387

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 2

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1386653889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 34TH AVE S",
            "address_2": "21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251672",
            "telephone_number": "952-883-5463",
            "fax_number": "952-883-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON STREET",
            "address_2": "MAIL STOP 11503P",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456",
            "fax_number": "651-254-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTAN",
        "first_name": "RORY",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1466326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "524161800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "68S33KO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.