Individual provider Active NPI

Clinton John Prasnicki, CRNA

  • Certified Registered Nurse Anesthetist
  • Mankato, MN
National Provider Identifier
1831697069
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2649 Issued in MN
Practice address
1025 Marsh St
Mankato, MN 56001
Phone
(507) 625-4031
NPI assigned
Jan 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP136239 TX
Certified Registered Nurse Anesthetist 367500000X 2649 MN Primary

Addresses

Primary practice location

1025 Marsh St
Mankato, MN 56001

Mailing address

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

Other practice location 1

3705 Medical Pkwy Ste 570
Austin, TX 78705
Phone (512) 454-2554

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CPRASNICKI1651134@EHRDIRECT.MAYOCLINICMSG.ORG

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211213000242 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002177870 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
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

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Mayo Clinic Health System - Mankato Hospital, Mankato, MN, CCN 240093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1649MNMDFamily Nurse Practitioner
2649MNMDCertified Registered Nurse Anesthetist
AP136239TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Dec 3, 2021 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Dec 6, 2021 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Dec 6, 2021 Accepting new patients

Locations

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

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

301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431

Interoperability endpoints

  • Direct secure messaging: cprasnicki1651134@ehrdirect.mayoclinicmsg.org

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 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": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1831697069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3705 Medical Pkwy Ste 570",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78705",
            "country_code": "US",
            "telephone_number": "512-454-2554",
            "fax_number": "512-454-2824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRASNICKI",
        "first_name": "CLINTON",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-23",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP136239",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "2649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CPRASNICKI1651134@EHRDIRECT.MAYOCLINICMSG.ORG",
            "affiliation": "N",
            "address_1": "1025 Marsh St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.