NPIMap

Individual provider Active NPI

Onikepo Omotoso, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Paul, MN
National Provider Identifier
1578042826
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R177670-2 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-6512
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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 R177670-2 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-3980

Other practice location 1

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-3980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181101000862 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709139173 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesia Providers LLCGroup PAC ID 7315986064, 325 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7000

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (651) 262-7633

3701 12TH St N
Suite 202
Saint Cloud, MN 56303-2253
Phone (320) 258-3090

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2252MNMDMarriage & Family Therapist
R177670-2MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2022 Accepting new patients
Anesthesiology, P.a. Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2020 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2024 Accepting new patients
Allina Health System Nurse Anesthetist, Certified Registered CurrentSince Jan 27, 2025 Accepting new patients
Regions Hospital CurrentSince Aug 7, 2023 Accepting new patients
Centracare Clinic CurrentSince Apr 13, 2024 Accepting new patients
Centracare Clinic CurrentSince Apr 13, 2024 Accepting new patients
Allina Health System CurrentSince Jan 27, 2025 Accepting new patients
Centracare Clinic Current Accepting new patients
Allina Health System Current Accepting new patients
Regions Hospital CurrentSince Aug 7, 2023 Accepting new patients

Locations

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

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

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

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

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

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

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

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

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

3701 12th St N
Ste 202
Saint Cloud, MN 56303
Phone (320) 258-3090

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

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

Interoperability endpoints

  • Direct secure messaging: oomotoso811116@direct.centracare.com

Organizations & group practices 11

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 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1578042826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-581-3980",
            "fax_number": "763-581-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-6512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Oakdale Ave N",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "554222926",
            "country_code": "US",
            "telephone_number": "763-581-3980",
            "fax_number": "763-581-3591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMOTOSO",
        "first_name": "ONIKEPO",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R177670-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.