NPIMap

Individual provider Active NPI

Travis Tanberg

  • Certified Registered Nurse Anesthetist
  • Saint Paul, MN
National Provider Identifier
1881059467
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
109295 Issued in MN
Practice address
333 Smith Ave N
Saint Paul, MN 55102-2344
Phone
(651) 697-5804
NPI assigned
Dec 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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 109295 MN Primary

Addresses

Primary practice location

333 Smith Ave N
Saint Paul, MN 55102-2344

Mailing address

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 697-5804

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160205000810 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931403375 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesia Providers LLCGroup PAC ID 7315986064, 325 clinicians
Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians

Practice addresses (Care Compare)

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

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (763) 236-6786

Hospital & facility affiliations

National Provider Directory

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

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 Mar 17, 2024 Accepting new patients

Locations

14500 99th Ave N
Ste 500
Maple Grove, MN 55369
Phone (763) 898-1400

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

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

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

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

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1881059467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022344",
            "telephone_number": "651-697-5804"
        },
        {
            "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": "651-697-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANBERG",
        "first_name": "TRAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "109295",
            "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 Dec 23, 2015; 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.