Individual provider Active NPI

Elizabeth J Kroutil, CRNA

  • Certified Registered Nurse Anesthetist
  • Coon Rapids, MN
National Provider Identifier
1871595546
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R 095814-9 Issued in MN
Practice address
8990 Springbrook Dr NW
Coon Rapids, MN 55433-5884
Phone
(763) 398-0099
Fax
(763) 398-0124
NPI assigned
Aug 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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 095814-9 MN Primary

Addresses

Primary practice location

8990 Springbrook Dr NW
Coon Rapids, MN 55433-5884

Mailing address

10365 Otchipwe Ave N
Stillwater, MN 55082-9544

Other identifiers 2

IdentifierTypeStateIssuer
711120700MedicaidMN
776S4KROtherMNBCBSMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210422000855 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547157406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 Glades Rd
Boca Raton, FL 33432-1419
Phone (954) 939-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 095814-9MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Lucie Anesthesia Associates LLC CurrentSince Apr 1, 2021 Accepting new patients
St Lucie Anesthesia Associates LLC Current Accepting new patients
St. Lucie Anesthesia Associates, LLC CurrentSince Apr 1, 2021 Accepting new patients
American Anesthesiology of Minnesota, P.a. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

501 Glades Rd
Boca Raton, FL 33432
Phone (561) 362-4400

3995 NW Goldenrod Rd
Jensen Beach, FL 34957
Phone (772) 497-0020

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1871595546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10365 OTCHIPWE AVE N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550829544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335884",
            "telephone_number": "763-398-0099",
            "fax_number": "763-398-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROUTIL",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R 095814-9",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "711120700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "776S4KR",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.