Active NPI
Michael Koss
- Certified Registered Nurse Anesthetist
- Plymouth, MN
National Provider Identifier
1437032836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 3407
- Practice address
- 14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876 - Phone
- (763) 559-3779
- Fax
- (763) 450-3986
- NPI assigned
- Jul 31, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 2285085 | MN | |
| Certified Registered Nurse Anesthetist | 367500000X | 3407 | MN | Primary |
Addresses
Primary practice location
14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876
Mailing address
PO Box 47159
Plymouth, MN 55447-0159
Phone (763) 559-3779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2285085 | MN | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789084800000",
"number": "1437032836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 47159",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554470159",
"telephone_number": "763-559-3779",
"fax_number": "763-450-3986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14700 28TH AVE N STE 20",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554474876",
"telephone_number": "763-559-3779",
"fax_number": "763-450-3986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSS",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-07-31",
"last_updated": "2026-09-11",
"certification_date": "2026-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MN",
"license": "2285085",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "3407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.