Anthony Dominick Mullozzi III, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Duluth, MN
NPI 1649580366 · NPPES record last updated Dec 18, 2020
Key facts
- NPI
- 1649580366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- R 137974-3 (MN)
- Practice address
- 915 E 1St St
Duluth, MN 55805-2107 - Phone
- (218) 249-5555
- NPI assigned
- Oct 15, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 32
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St. Luke'S Hospital of Duluth
Practice addresses (Care Compare)
1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000
1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860
915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5439
Hospital & facility affiliations
- St Lukes Hospital
- Aspirus Ironwood Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110309000836 | MN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 8729260948 | Reassigns benefits to 3 organizations |
| I20111021000233 | WI | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 8729260948 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 137974-3 | MN | MD | Certified Registered Nurse Anesthetist |
| 512 | MN | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake View Memorial Hospital, Inc. | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| St. Luke'S Hospital of Duluth | Current |
Accepting new patients | |
| St. Luke'S Hospital of Duluth | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current |
Accepting new patients | |
| Lake View Memorial Hospital, Inc. | Current |
Accepting new patients | |
| Lake View Memorial Hospital, Inc | Current | Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860
915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352
325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520
109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R 137974-3 | MN | Yes |
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 names
- Nick Mullozzi III
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@slk.direct.slhduluth.com |
Other providers in Duluth, MN
- Rachel Marie Mueller
- Nayyer Mian Mujteba
- Shawn Michael Mullen
- Daniel John Mullins
- Mia C Mullins
- Richard D Mullvain
- Jeffrey Alan Mundhenke
- Frank Clark Munns
- Abbygail Marie Munsterteiger
- Courtney F Murphy-Bakken
All providers in Duluth, MN · Certified Registered Nurse Anesthetist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.