Active NPI
Amy J Vetruba, CRNA
- Certified Registered Nurse Anesthetist
- Saint Paul, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R11414586
- Practice address
- 333 Smith Ave N
Saint Paul, MN 55102-2344 - Phone
- (651) 735-0501
- Fax
- (651) 735-1870
- NPI assigned
- Apr 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R11414586 | MN | Primary |
Addresses
Primary practice location
333 Smith Ave N
Saint Paul, MN 55102-2344
Mailing address
8681 Eagle Point Blvd
Lake Elmo, MN 55042-8628
Phone (651) 251-8021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 642643300 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
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)
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R11414586 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Anesthesia Network, LLP | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700
4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786
2020 E 28th St
Ste 100
Minneapolis, MN 55407
Phone (612) 455-0612
14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779
333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256
1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Plymouth, MN
- NPI 1558314427
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 16
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- St Paul, MN
- NPI 1265474704
Hospital
-
- General Acute Care Hospital
- Saint Paul, MN
- NPI 1457319485
-
- General Acute Care Hospital
- Hastings, MN
- NPI 1508457045
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286409600000",
"number": "1952368326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8681 EAGLE POINT BLVD",
"city": "LAKE ELMO",
"state": "MN",
"postal_code": "550428628",
"telephone_number": "651-251-8021",
"fax_number": "651-251-8050"
},
{
"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": "651-735-0501",
"fax_number": "651-735-1870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VETRUBA",
"first_name": "AMY",
"middle_name": "J",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-28",
"last_updated": "2010-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "R11414586",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "642643300",
"state": "MN"
}
],
"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 Oct 7, 2010; 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.