NPIMap

Individual provider Active NPI

Benjamin M Johnsen, CRNA

  • Certified Registered Nurse Anesthetist
  • Duluth, MN
National Provider Identifier
1598059974
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1131 Issued in MN
Practice address
915 E 1St St
Duluth, MN 55805-2107
Phone
(218) 249-5555
NPI assigned
Jun 3, 2011
Last updated
May 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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 1131 MN Primary

Addresses

Primary practice location

915 E 1St St
Duluth, MN 55805-2107

Mailing address

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5555

Other practice location 1

400 E 3rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110719000349 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759559784 Reassigns benefits to 6 organizations
I20200713003661 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759559784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, shared by 9 NPIs, 409 clinicians

Practice addresses (Care Compare)

109 N 28TH St E
Superior, WI 54880-6548
Phone (715) 395-3990

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth Nurse Anesthetist, Certified Registered CurrentSince May 1, 2020 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Jun 20, 2011 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Jun 20, 2011 Accepting new patients
Northland Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince May 1, 2023 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
North Shore Anesthesia P.a Nurse Anesthetist, Certified Registered CurrentSince Sep 24, 2021 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

10 5th St SE
Cook, MN 55723
Phone (218) 626-3441

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

1420 London Rd
Ste 100
Duluth, MN 55805
Phone (218) 728-0650

2118 London Rd
Duluth, MN 55812
Phone (218) 481-7812

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1542 Golf Course Rd
Ste 105
Grand Rapids, MN 55744
Phone (218) 326-0667

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

325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

400 10th St E
Waconia, MN 55387

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Organizations & group practices 8

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 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1598059974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "218-249-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "218-249-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051951",
            "country_code": "US",
            "telephone_number": "218-786-8364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSEN",
        "first_name": "BENJAMIN",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-03",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "1131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "915 E 1st St",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558052107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.