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Phillip Edward Green

Individual provider Active NPI Certified Registered Nurse Anesthetist · Minneapolis, MN

NPI 1639697386 · NPPES record last updated Nov 3, 2017

Key facts

NPI
1639697386
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
2126 (MN)
Practice address
800 E 28TH St
Minneapolis, MN 55407-3723
Phone
(612) 863-4000
NPI assigned
Sep 1, 2017
Sex
Male
Sole proprietor
No

Organizations & group practices 19

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 9

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

Medicare Care Compare profile

Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesia Providers LLC (325 clinicians)
Centracare Clinic (800 clinicians)
Metropolitan Anesthesia Network LLP (516 clinicians)

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-4097

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

800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 863-5370

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital · Minneapolis, MN · CCN 240080
  • Centracare - St. Cloud Hospital Hospital · Saint Cloud, MN · CCN 240036

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20171122000163 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082971312 Reassigns benefits to 5 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southdale Anesthesiologists, LLC Current
since Oct 1, 2022		 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered Current
since Sep 1, 2024		 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered Current
since Feb 3, 2020		 Accepting new patients
Anesthesiology, P.a. Nurse Anesthetist, Certified Registered Current
since Jan 1, 2020		 Accepting new patients
Centracare Clinic Current
since Feb 1, 2026		 Accepting new patients
Centracare Clinic Current
since Feb 1, 2026		 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

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

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

2450 Riverside Ave
Fl 12
Minneapolis, MN 55454
Phone (612) 273-5000

8100 W 78th St
Ste 220
Minneapolis, MN 55439
Phone (952) 914-8400

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

4100 Minnesota Dr
Ste 200
Minneapolis, MN 55435
Phone (952) 996-9600

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

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2126 MN Yes

Addresses

Primary practice location

800 E 28TH St
Minneapolis, MN 55407-3723

Mailing address

2040 Shenandoah CT Unit C
Plymouth, MN 55447-6421
Phone (320) 237-6548

Other providers in Minneapolis, MN

All providers in Minneapolis, MN · Certified Registered Nurse Anesthetist in Minnesota

Sources for this page

Verify at the official NPI Registry.