Individual provider Active NPI

Monica S Lucus, CRNA

  • Certified Registered Nurse Anesthetist
  • Coon Rapids, MN
National Provider Identifier
1992706147
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1179192 Issued in MN
Practice address
8990 Springbrook Dr NW
Suite 250
Coon Rapids, MN 55433-5850
Phone
(763) 398-1162
Fax
(763) 398-0124
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 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 R1179192 MN Primary

Addresses

Primary practice location

8990 Springbrook Dr NW
Suite 250
Coon Rapids, MN 55433-5850

Mailing address

1365 14TH Ave SE
Forest Lake, MN 55025-2077

Other identifiers 2

IdentifierTypeStateIssuer
016T1ANOtherMNBCBSMN
610089900MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110120000413 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941489165 Reassigns benefits to 4 organizations

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
Regions HospitalGroup PAC ID 3173436755, 215 clinicians

Practice addresses (Care Compare)

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7700

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-8080

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-2164

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1179192MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Jan 26, 2022 Accepting new patients
Certified Anesthesia Care, Co. Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Regions Hospital CurrentSince Nov 1, 2013 Accepting new patients
Twin Cities Anesthesia Associates PC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2017 Accepting new patients
Regions Hospital CurrentSince Nov 1, 2013 Accepting new patients

Locations

11091 Ulysses St NE
Ste 400
Blaine, MN 55434
Phone (763) 421-9410

9801 DuPont Ave S
Ste 100
Bloomington, MN 55431

11855 Ulysses St NE
Minneapolis, MN 55434
Phone (763) 420-1010

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

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

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

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

400 10th St E
Waconia, MN 55387

7125 Tamarack Rd
Ste 200
Woodbury, MN 55125
Phone (651) 748-4444

Organizations & group practices 5

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1992706147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 14TH AVE SE",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 SPRINGBROOK DR NW",
            "address_2": "SUITE 250",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335850",
            "telephone_number": "763-398-1162",
            "fax_number": "763-398-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCUS",
        "first_name": "MONICA",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1179192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "016T1AN",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "610089900",
            "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 22, 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.