Individual provider Active NPI

Michelle Lynn Sklader, RN, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Paul, MN
National Provider Identifier
1720218928
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1688573 Issued in MN
Practice address
333 Smith Ave N
Saint Paul, MN 55102-2344
Phone
(651) 209-8071
Fax
(651) 209-8077
NPI assigned
Jul 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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 R1688573 MN Primary

Addresses

Primary practice location

333 Smith Ave N
Saint Paul, MN 55102-2344

Mailing address

8681 Eagle Point Blvd
Lake Elmo, MN 55042-8628
Phone (651) 209-8071

Other names 1

  • Michelle Lynn Burque Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090924000078 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416003942 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1688573MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2019 Accepting new patients
Associated Anesthesiologists PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

2020 E 28th St
Ste 100
Minneapolis, MN 55407
Phone (612) 455-0612

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

2080 Woodwinds Dr
Ste 200
Woodbury, MN 55125
Phone (651) 642-1106

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.

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1720218928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8681 EAGLE POINT BLVD",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428628",
            "telephone_number": "651-209-8071",
            "fax_number": "651-209-8077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022344",
            "telephone_number": "651-209-8071",
            "fax_number": "651-209-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKLADER",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "credential": "RN, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1688573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "BURQUE",
            "middle_name": "LYNN",
            "credential": "RN, CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.