Grant Tyler Brekken, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

104950 Issued in MN

Practice address

2700 Snelling Ave N
Ste 400
Roseville, MN 55113-1719

Phone

(651) 697-5863

Fax

(855) 826-4934

NPI assigned

Feb 3, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: grant.brekken@cumberland-directmessage.com

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.

• Metropolitan Anesthesia Network, LLP

  • Anesthesiology Physician
  • Plymouth, MN
  • NPI 1558314427

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Mngi Digestive Health, P.a.

  • Gastroenterology Physician
  • Minneapolis, MN
  • NPI 1609804541
  Medicare reassignment NPD
• Twin Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Blaine, MN
  • NPI 1265105332

  Nurse Anesthetist, Certified Registered, WI

  Medicare reassignment NPD
• Advanced Surgical and Restorative Care LLC

  • Ambulatory Surgical Clinic/Center
  • Altoona, WI
  • NPI 1194466235
  Medicare reassignment NPD
• Baldwin Area Medical Center, Inc.

  • Critical Access Hospital
  • Baldwin, WI
  • NPI 1467496133
  Medicare reassignment NPD
• Advanced Surgical and Restorative Care LLC

  • Certified Registered Nurse Anesthetist
  • Altoona, WI
  • NPI 1952004863

  Nurse Anesthetist, Certified Registered

  NPD
• Baldwin Area Medical Center Inc.

  • Clinic/Center
  • Spring Valley, WI
  • NPI 1164272324
  NPD

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1881084408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15525 EAGLE SHORE DR",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247831",
            "telephone_number": "612-247-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SNELLING AVE N",
            "address_2": "STE 400",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131719",
            "telephone_number": "651-697-5863",
            "fax_number": "855-826-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREKKEN",
        "first_name": "GRANT",
        "middle_name": "TYLER",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-03",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "104950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Bradway, PA-C
• Brain Injury Association of Minnesota
• Braincare, LLC
• Michael Anthony Branchaud, LPC
• Breakthrough Medical Supply Inc
• Bright Future Therapy Inc
• Bright Futures Homecare LLC
• Sonja Brockman, DNP, FNP-BC
• Matthew Edward Bross, PHARM D
• Mary Brown-Kelly

• Certified Registered Nurse Anesthetist in Roseville, MN
• Providers in Roseville, MN by specialty
• Certified Registered Nurse Anesthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.