Individual provider Active NPI

Tyler William Freiborg, CRNA

  • Registered Nurse
  • Edina, MN
National Provider Identifier
1760098156
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1912090 Issued in MN
Practice address
6401 France Ave S
Edina, MN 55435-2104
Phone
(952) 924-5000
NPI assigned
Sep 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1912090 MN Primary

Addresses

Primary practice location

6401 France Ave S
Edina, MN 55435-2104

Mailing address

6020 Oakland Ave
Minneapolis, MN 55417-3118
Phone (651) 231-9268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210218000837 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739594086 Reassigns benefits to 3 organizations
I20240221003925 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739594086 Reassigns benefits to 1 organization

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
Glenwood Anesthesia Professionals, PCGroup PAC ID 6800015843, 24 clinicians

Practice addresses (Care Compare)

1906 Blake Ave
Glenwood SPGS, CO 81601-4227
Phone (970) 945-7564

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1912090MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Glenwood Anesthesia Professionals, PC CurrentSince Dec 5, 2023 Accepting new patients
University Anesthesia Providers, LLC CurrentSince Jan 4, 2021 Accepting new patients
Metropolitan Anesthesia Network, LLP CurrentSince Jun 1, 2023 Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Mar 1, 2021 Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Mar 1, 2021 Accepting new patients

Locations

1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

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

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

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

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

Organizations & group practices 5

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 2

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": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1760098156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 OAKLAND AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554173118",
            "telephone_number": "651-231-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352104",
            "telephone_number": "952-924-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIBORG",
        "first_name": "TYLER",
        "middle_name": "WILLIAM",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "1912090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.