Individual provider Active NPI

Cheryll Martiny-Jorgensen, CRNA

  • Certified Registered Nurse Anesthetist
  • Hudson, WI
National Provider Identifier
1598726549
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R121660-2 Issued in MN
Practice address
1110 Partridge LN
Hudson, WI 54016-2316
Phone
(651) 592-8216
Fax
(715) 386-5072
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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 R121660-2 MN Primary

Addresses

Primary practice location

1110 Partridge LN
Hudson, WI 54016-2316

Mailing address

1110 Partridge LN
Hudson, WI 54016-2316

Other identifiers 1

IdentifierTypeStateIssuer
040348-00MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040220000776 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890680417 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Twin Cities Anesthesia Associates PCGroup PAC ID 9133491194, 72 clinicians

Practice addresses (Care Compare)

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-3456

Hospital & facility affiliations

  • Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1610MNMDMarriage & Family Therapist
R121660-2MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2018 Accepting new patients
Twin Cities Anesthesia Associates PC Nurse Anesthetist, Certified Registered CurrentSince Jan 20, 2018 Accepting new patients
Certified Anesthesia Care, Co. Nurse Anesthetist, Certified Registered CurrentSince Jan 15, 2018 Accepting new patients
Hennepin County Past Accepting new patients

Locations

9801 DuPont Ave S
Ste 100
Bloomington, MN 55431

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

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

2020 E 28th St
Ste 100
Minneapolis, MN 55407
Phone (612) 455-0612

11855 Ulysses St NE
Minneapolis, MN 55434
Phone (763) 420-1010

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

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

2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000

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

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

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

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

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

400 10th St E
Waconia, MN 55387

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

Organizations & group practices 4

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

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1598726549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 PARTRIDGE LN",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540162316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 PARTRIDGE LN",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540162316",
            "telephone_number": "651-592-8216",
            "fax_number": "715-386-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINY-JORGENSEN",
        "first_name": "CHERYLL",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R121660-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040348-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.