Individual provider Active NPI

Tara Simpson

  • Certified Registered Nurse Anesthetist
  • St. Paul, MN
National Provider Identifier
1770029720
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2239 Issued in MN
Practice address
640 Jackson Street Mail Stop 13901C
St. Paul, MN 55101-2502
Phone
(651) 254-3456
NPI assigned
Jan 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X R202537-1 MN
Certified Registered Nurse Anesthetist 367500000X 120873 MN
Certified Registered Nurse Anesthetist 367500000X 2239 MN Primary

Addresses

Primary practice location

640 Jackson Street Mail Stop 13901C
St. Paul, MN 55101-2502

Mailing address

PO Box 1309 - Mail Stop 21110Q
Minneapolis, MN 55440

Other practice location 1

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-5006

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181025000366 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3274886007 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regions HospitalGroup PAC ID 3173436755, 215 clinicians

Practice addresses (Care Compare)

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-2164

Hospital & facility affiliations

  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R202537-1MNMDCritical Care Medicine Registered Nurse
120873MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince May 15, 2021 Accepting new patients
Regions Hospital CurrentSince Oct 4, 2018 Accepting new patients
Regions Hospital CurrentSince Oct 4, 2018 Accepting new patients
Regions Hospital Current Accepting new patients
Southdale Anesthesiologists, LLC CurrentSince Feb 15, 2021 Accepting new patients

Locations

11855 Ulysses St NE
Ste 270
Blaine, MN 55434
Phone (763) 755-6540

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

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

11855 Ulysses St NE
Minneapolis, MN 55434
Phone (763) 420-1010

4100 Minnesota Dr
Ste 200
Minneapolis, MN 55435
Phone (952) 996-9600

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

640 Jackson St
Stop 13901C
Saint Paul, MN 55101
Phone (641) 257-1771

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

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 8

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": "1484438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1770029720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309 - MAIL STOP 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON STREET MAIL STOP 13901C",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012502",
            "country_code": "US",
            "telephone_number": "651-254-5006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "TARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-15",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MN",
            "license": "R202537-1",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "120873",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "2239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.