NPIMap

Organization Active NPI

South Metropolitan Anesthesia, PA

  • Certified Registered Nurse Anesthetist
  • Burnsville, MN
National Provider Identifier
1649265737
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
SOUTH METROPOLITAN ANESTHESIA, PA
Practice address
201 E Nicollet Blvd
Burnsville, MN 55337
Phone
(888) 209-0305
Fax
(952) 442-3620
NPI assigned
Sep 14, 2005
Last updated
Aug 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Authorized official

Name
Paul D Schwichtenberg, CRNANPI 1730492604
Title
Ceo
Phone
(612) 387-1219

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

201 E Nicollet Blvd
Burnsville, MN 55337

Mailing address

400 10TH St E
Waconia, MN 55387-4552
Phone (888) 209-0305

Other practice location 1

14054 Bank St
Box 100
Becker, MN 55308-0100
Phone (763) 260-8808

Other practice location 2

14101 Fairview Dr
Burnsville, MN 55337-4590
Phone (888) 209-0305

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050119000369 MN Part B Supplier - Clinic/Group Practice 1153370911 Receives reassigned benefits from 48 practitioners
Practice locations: Burnsville, MN; St Paul, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565308800000",
    "number": "1649265737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 10TH ST E",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874552",
            "telephone_number": "888-209-0305",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E NICOLLET BLVD",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "55337",
            "telephone_number": "888-209-0305",
            "fax_number": "952-442-3620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14054 BANK ST",
            "address_2": "BOX 100",
            "address_purpose": "LOCATION",
            "city": "BECKER",
            "state": "MN",
            "postal_code": "553080100",
            "country_code": "US",
            "telephone_number": "763-260-8808",
            "fax_number": "763-645-5579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14101 Fairview Dr",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553374590",
            "country_code": "US",
            "telephone_number": "888-209-0305",
            "fax_number": "952-442-3620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH METROPOLITAN ANESTHESIA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2019-08-09",
        "status": "A",
        "authorized_official_last_name": "SCHWICHTENBERG",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-387-1219",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.