Individual provider Active NPI

Amy K Widell, CRNA

  • Certified Registered Nurse Anesthetist
  • Red Wing, MN
National Provider Identifier
1790790129
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R 147159-9 Issued in MN
Practice address
701 Fairview Blvd
Red Wing, MN 55066-2848
Phone
(612) 467-4698
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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 R 147159-9 MN Primary

Addresses

Primary practice location

701 Fairview Blvd
Red Wing, MN 55066-2848

Mailing address

2500 Westcliffe Dr
Burnsville, MN 55306-6905
Phone (952) 898-5179

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awidell88641@ehrdirect.mayoclinicmsg.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090318000487 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345307344 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, shared by 6 NPIs, 658 clinicians
Mayo Clinic Health System-Southeast Minnesota RegionGroup PAC ID 4385556703, shared by 9 NPIs, 550 clinicians

Practice addresses (Care Compare)

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

404 W Fountain St
Albert Lea, MN 56007-2437
Phone (507) 373-2384

701 Hewitt Blvd
Red Wing, MN 55066-2848
Phone (651) 267-5000

Hospital & facility affiliations

  • Mayo Clinic Health System in Red Wing Hospital, Red Wing, MN, CCN 240018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 147159-9MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 1, 2017 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince May 27, 2025 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Aug 6, 2021 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Apr 2, 2018 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 1, 2017 Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

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

701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

501 State St N
Waseca, MN 56093
Phone (507) 835-1210

Interoperability endpoints

  • Direct secure messaging: awidell88641@ehrdirect.mayoclinicmsg.org

Organizations & group practices 11

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 1

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1790790129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 WESTCLIFFE DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553066905",
            "telephone_number": "952-898-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 FAIRVIEW BLVD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662848",
            "telephone_number": "612-467-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDELL",
        "first_name": "AMY",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 147159-9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awidell88641@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "701 Fairview Blvd",
            "city": "Red Wing",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550662848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Red Wing, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.