Individual provider Active NPI

Mary E Krupich, CRNA

  • Certified Registered Nurse Anesthetist
  • Fargo, ND
National Provider Identifier
1730106402
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R25378 Issued in ND
Practice address
801 Broadway N
Fargo, ND 58102-3641
Phone
(701) 234-6259
Fax
(701) 234-7334
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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 R25378 ND Primary

Addresses

Primary practice location

801 Broadway N
Fargo, ND 58102-3641

Mailing address

PO Box 2168
Fargo, ND 58107-2168
Phone (701) 234-2119

Other identifiers 1

IdentifierTypeStateIssuer
12826MedicaidND

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkrupich819565@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, SD, MN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20101105000828 ND Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961697768 Reassigns benefits to 2 organizations
I20220310001677 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961697768 Reassigns benefits to 1 organization
I20221031002995 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961697768 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of North Dakota School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

1720 University Dr S
Fargo, ND 58103-4940
Phone (701) 234-2000

3701 12TH St N
Suite 202
Saint Cloud, MN 56303-2253
Phone (320) 258-3090

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000

Hospital & facility affiliations

  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2671MNMDAthletic Trainer
R25378NDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince May 18, 2011 Accepting new patients
Centracare Clinic CurrentSince Feb 1, 2025 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2023 Accepting new patients
St. Alexius Medical Center CurrentSince Feb 22, 2023 Accepting new patients
Centracare Clinic Current Accepting new patients
Avera St Lukes CurrentSince Feb 25, 2022 Accepting new patients
Centracare Clinic CurrentSince Feb 1, 2025 Accepting new patients
Sanford Medical Center Fargo CurrentSince May 18, 2011 Accepting new patients
Avera St. Lukes CurrentSince Feb 25, 2022 Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Jul 19, 2022 Accepting new patients
Astera Health Current Accepting new patients
St Alexius Medical Center CurrentSince Feb 22, 2023 Accepting new patients
Avera St. Luke'S Current Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Jul 19, 2022 Accepting new patients
Valley Anesthesia Associates PC Nurse Anesthetist, Certified Registered PastSince Jul 1, 1997 Accepting new patients
Plains Anesthesia, PLLC Nurse Anesthetist, Certified Registered PastSince Jan 1, 2017 Accepting new patients

Locations

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

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

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

3701 12th St N
Ste 202
Saint Cloud, MN 56303
Phone (320) 258-3090

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

305 S State St
Aberdeen, SD 57401
Phone (605) 229-3000

Interoperability endpoints

  • Direct secure messaging: mkrupich819565@direct.centracare.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 11

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1730106402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581072168",
            "telephone_number": "701-234-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-6259",
            "fax_number": "701-234-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUPICH",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R25378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12826",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkrupich819565@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mkrupich819565@direct.centracare.com",
            "address_1": "3701 12th St N Ste 202",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563032253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.