Individual provider Active NPI

Gregory John Mohrenweiser, CRNA

  • Certified Registered Nurse Anesthetist
  • Minnetonka, MN
National Provider Identifier
1386797512
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R0870803 Issued in MN
Practice address
13911 Ridgedale Dr
Suite 350
Minnetonka, MN 55305-1771
Phone
(952) 932-9012
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R0870803 MN Primary

Addresses

Primary practice location

13911 Ridgedale Dr
Suite 350
Minnetonka, MN 55305-1771

Mailing address

8489 State Highway 27
Onamia, MN 56359-7848

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040818001363 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224001094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Anesthesia Services PAGroup PAC ID 0648250548, 12 clinicians

Practice addresses (Care Compare)

Minnetonka, MN 55305
Phone (612) 810-4738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33750MNMDInternal Medicine Physician
R0870803MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Glacial Ridge Hospital District Current Accepting new patients
Glacial Ridge Hospital District CurrentSince Jan 1, 2015 Accepting new patients
Regional Anesthesia Services PA CurrentSince Mar 31, 2020 Accepting new patients
Glacial Ridge Hospital District CurrentSince Jan 1, 2015 Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157

417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157

13911 Ridgedale Dr
Ste 404B
Minnetonka, MN 55305
Phone (612) 636-0061

13911 Ridgedale Dr
Ste 350
Minnetonka, MN 55305
Phone (952) 932-0998

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c

Organizations & group practices 4

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386797512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8489 STATE HIGHWAY 27",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563597848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13911 RIDGEDALE DR",
            "address_2": "SUITE 350",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051771",
            "telephone_number": "952-932-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHRENWEISER",
        "first_name": "GREGORY",
        "middle_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R0870803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.