Active NPI
Peter Tierney, CRNA
- Certified Registered Nurse Anesthetist
- Plymouth, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2801
- Practice address
- 14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876 - Phone
- (763) 559-3779
- Fax
- (763) 450-3986
- NPI assigned
- Nov 17, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2801 | MN | Primary |
Addresses
Primary practice location
14700 28TH Ave N Ste 20
Plymouth, MN 55447-4876
Mailing address
PO Box 47159
Plymouth, MN 55447-0159
Phone (763) 559-3779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 464-4611
Hospital & facility affiliations
- Fairview Lakes Health Services
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2801 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Metro Anesthesia Services P.a. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Metropolitan Anesthesia Network, LLP | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
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
1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000
400 10th St E
Waconia, MN 55387
5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611
Organizations & group practices 2
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.
-
- Certified Registered Nurse Anesthetist
- Wyoming, MN
- NPI 1457339780
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Plymouth, MN
- NPI 1558314427
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674000000000",
"number": "1710696745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 47159",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554470159",
"telephone_number": "763-559-3779",
"fax_number": "763-450-3986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14700 28TH AVE N STE 20",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554474876",
"telephone_number": "763-559-3779",
"fax_number": "763-450-3986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIERNEY",
"first_name": "PETER",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-17",
"last_updated": "2023-01-18",
"certification_date": "2023-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "2801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.