Individual provider Active NPI

Jessika Marie-Alyce Belde, CRNA

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
National Provider Identifier
1538710645
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2414 Issued in MN
Practice address
500 Harvard St SE
Minneapolis, MN 55455-0363
Phone
(612) 273-3000
NPI assigned
Sep 20, 2019
Last updated
Jan 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2414 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X MN
Critical Care Medicine Registered Nurse 163WC0200X 2112585 MN

Addresses

Primary practice location

500 Harvard St SE
Minneapolis, MN 55455-0363

Mailing address

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 273-3000

Other names 1

  • Jessika Marie-Alyce Phipps Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200330002222 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3476982257 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology, P.a.Group PAC ID 9335033034, 136 clinicians

Practice addresses (Care Compare)

9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 898-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2112585MNMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology, P.a. Nurse Anesthetist, Certified Registered CurrentSince Mar 22, 2021 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 19, 2020 Accepting new patients

Locations

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

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

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

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

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

Organizations & group practices 2

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 1

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": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1538710645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HARVARD ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550363",
            "telephone_number": "612-273-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HARVARD ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550363",
            "telephone_number": "612-273-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELDE",
        "first_name": "JESSIKA",
        "middle_name": "MARIE-ALYCE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "2414",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MN",
            "license": "2112585",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIKA",
            "last_name": "PHIPPS",
            "middle_name": "MARIE-ALYCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.