Individual provider Active NPI

Andrew Sacquitne

  • Certified Registered Nurse Anesthetist
  • Iowa City, IA
National Provider Identifier
1649777293
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
10167-33 Issued in WI
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-1616
NPI assigned
Apr 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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 10167-33 WI Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

424 6TH Ave Apt 407
Coralville, IA 52241-2365
Phone (563) 379-4131

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200926000161 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325467244 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nurse Anesthesia Professional Services LLC 8 clinicians
Prairie Ridge Health Inc 70 clinicians

Practice addresses (Care Compare)

1077 W Mason St
Green Bay, WI 54303-1858
Phone (920) 497-1810

1515 Park Ave
Columbus, WI 53925-1618
Phone (920) 623-2200

Hospital & facility affiliations

  • Columbus Community Hospital Hospital, Columbus, WI, CCN 521338

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Ridge Health, Inc. CurrentSince Jan 1, 2022 Accepting new patients
Edgerton Hospital and Health Services Inc. CurrentSince May 28, 2025 Accepting new patients
Edgerton Hospital and Health Services, Inc CurrentSince May 28, 2025 Accepting new patients
Prairie Ridge Health, Inc. Current Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Sacquitne Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 28, 2023 Accepting new patients
Prairie Ridge Health Inc. CurrentSince Jan 1, 2022 Accepting new patients
Prairie Ridge Health, Inc. Current Accepting new patients
Nurse Anesthesia Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients

Locations

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

11101 N Sherman Rd
Edgerton, WI 53534
Phone (608) 884-1695

277 N Altenhofen Dr
Grand Chute, WI 54913
Phone (920) 212-3609

1077 W Mason St
Green Bay, WI 54303
Phone (920) 497-1810

831 Arthur Dr
Milton, WI 53563
Phone (608) 868-3526

425 S Commercial St
Neenah, WI 54956
Phone (920) 725-0700

Organizations & group practices 10

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 3

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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1649777293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 6TH AVE APT 407",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412365",
            "telephone_number": "563-379-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACQUITNE",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "10167-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.