Individual provider Active NPI

Tiffany Lee Petersen

  • Certified Registered Nurse Anesthetist
  • Eau Claire, WI
National Provider Identifier
1861169716
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11741 Issued in WI
Practice address
2116 Craig Rd
Eau Claire, WI 54701-6118
Phone
(715) 858-4500
NPI assigned
Aug 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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 137670 WI
Certified Registered Nurse Anesthetist 367500000X 11741 WI Primary

Addresses

Primary practice location

2116 Craig Rd
Eau Claire, WI 54701-6118

Mailing address

2116 Craig Rd
Eau Claire, WI 54701-6118

Other practice location 1

1629 E Division St
River Falls, WI 54022-1571
Phone (715) 307-6000

Other practice location 2

18606 Ervin St
Whitehall, WI 54773-8613
Phone (715) 538-4355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211222001153 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880085034 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, 797 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians
MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians

Practice addresses (Care Compare)

1221 Whipple St
Eau Claire, WI 54703-5270
Phone (715) 838-3806

1629 E Division St
River Falls, WI 54022-1571
Phone (715) 307-6000

2116 Craig Rd
Eau Claire, WI 54701-6149
Phone (715) 858-4500

Hospital & facility affiliations

  • Mayo Clinic Health System Eau Claire Hospital Hospital, Eau Claire, WI, CCN 520070
  • Marshfield Medical Center - Eau Claire Hospital, Eau Claire, WI, CCN 520210
  • River Falls Area Hospital Hospital, River Falls, WI, CCN 521349

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11741WIMDCertified Registered Nurse Anesthetist
137670WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc CurrentSince Jan 17, 2022 Accepting new patients
Allina Health System Nurse Anesthetist, Certified Registered CurrentSince Jun 28, 2025 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Jan 10, 2024 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Jan 14, 2026 Accepting new patients
North American Partners in Anesthesia Wisconsin SC CurrentSince May 22, 2023 Accepting new patients
Independent Surgery Center LLC CurrentSince Jul 20, 2023 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Black River Memorial Hospital Inc CurrentSince Mar 1, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Sep 8, 2025 Accepting new patients
Black River Health Inc CurrentSince Mar 1, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Jan 17, 2022 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Marshfield Clinic Inc CurrentSince Jan 17, 2022 Accepting new patients
Black River Health Inc Current Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Jan 10, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Sep 8, 2025 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Allina Health System CurrentSince Jun 28, 2025 Accepting new patients

Locations

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302

2751 Commercial Blvd
Ste 7
Chippewa Fls, WI 54729
Phone (715) 738-1800

2116 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

900 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 717-4121

1221 Whipple St
Eau Claire, WI 54703
Phone (715) 831-0100

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

18601 Lincoln St
Whitehall, WI 54773
Phone (715) 538-1712

18606 Ervin St
Whitehall, WI 54773
Phone (715) 538-4330

Interoperability endpoints

  • Direct secure messaging: tpetersen830883@direct.emplifyhealth.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/7b17929a-d976-4002-b080-2a37b05f2444/

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 6

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": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1861169716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 CRAIG RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 CRAIG RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016118",
            "telephone_number": "715-858-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1629 E Division St",
            "address_purpose": "LOCATION",
            "city": "River Falls",
            "state": "WI",
            "postal_code": "540221571",
            "country_code": "US",
            "telephone_number": "715-307-6000",
            "fax_number": "715-426-4660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18606 Ervin St",
            "address_purpose": "LOCATION",
            "city": "Whitehall",
            "state": "WI",
            "postal_code": "547738613",
            "country_code": "US",
            "telephone_number": "715-538-4355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "TIFFANY",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "137670",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "11741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.