Individual provider Active NPI

Leann Margaret Krezowski, CNP

  • Primary Care Nurse Practitioner
  • Edina, MN
National Provider Identifier
1538612940
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
CNP 4430 Issued in MN
Practice address
3400 W 66TH St Ste 290
Edina, MN 55435-2133
Phone
(952) 914-1733
NPI assigned
Aug 2, 2016
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X CNP 4430 MN Primary

Addresses

Primary practice location

3400 W 66TH St Ste 290
Edina, MN 55435-2133

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (651) 850-7739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161026002892 MN Practitioner - Nurse Practitioner 0840578894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (952) 914-1732

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP 4430MNMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Sep 30, 2016 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Sep 30, 2016 Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Interoperability endpoints

  • Direct secure messaging: lkrezowski337796@fairview.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1538612940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "651-850-7739",
            "fax_number": "651-326-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST STE 290",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352133",
            "telephone_number": "952-914-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREZOWSKI",
        "first_name": "LEANN",
        "middle_name": "MARGARET",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "CNP 4430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.