Individual provider Active NPI

Jeremy Lee Mabis-Rowe, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Paul, MN
National Provider Identifier
1841704293
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2151 Issued in MN
Practice address
333 Smith Ave N
Saint Paul, MN 55102-2344
Phone
(727) 210-8236
NPI assigned
Nov 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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 1864737 MN
Certified Registered Nurse Anesthetist 367500000X 2151 MN Primary

Addresses

Primary practice location

333 Smith Ave N
Saint Paul, MN 55102-2344

Mailing address

4936 30TH Ave S
Minneapolis, MN 55417-1308
Phone (612) 819-3874

Other practice location 1

2700 Snelling Ave N Ste 400
Roseville, MN 55113-1783
Phone (651) 697-5804

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180222000280 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547521130 Reassigns benefits to 4 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
University Anesthesia Providers LLCGroup PAC ID 7315986064, 325 clinicians
Anesthesiology, P.a.Group PAC ID 9335033034, 136 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-4097

3300 N Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-5370

Hospital & facility affiliations

  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1864737MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2019 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2024 Accepting new patients
Anesthesiology, P.a. Nurse Anesthetist, Certified Registered CurrentSince Aug 18, 2023 Accepting new patients
Eye Clinic of Faribault PA CurrentSince Mar 31, 2022 Accepting new patients

Locations

1575 20th St NW
Ste 101
Faribault, MN 55021
Phone (507) 332-6800

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

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

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

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

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

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

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

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

Interoperability endpoints

  • Direct secure messaging: jeremy.mabisrowe.p21@direct.painphysicians.nextgenshare.com

Organizations & group practices 4

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 7

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": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1841704293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4936 30TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171308",
            "telephone_number": "612-819-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022344",
            "telephone_number": "727-210-8236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Snelling Ave N Ste 400",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MN",
            "postal_code": "551131783",
            "country_code": "US",
            "telephone_number": "651-697-5804",
            "fax_number": "916-533-0045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MABIS-ROWE",
        "first_name": "JEREMY",
        "middle_name": "LEE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-21",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "1864737",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "2151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.