Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1083616627

Certified Registered Nurse Anesthetist

Unknown Individual is a healthcare provider. based in Vadnais heights, Minnesota. specializing in Certified Registered Nurse Anesthetist. They hold a License No. R 087703-9 (MN). The NPI Number for Unknown Individual is 1083616627

Main info

Organization

Inactive

32 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1083616627

Phone

Not provided

Address

512 OAK CREEK DR S

Deactivation Date

13 February 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

6512543456

Graduation Year

1994 (32 years ago)

PAC ID

5395924526

Group Practice PAC ID

9133491194

Professional Enrollment ID

I20110120000432

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

512, Oak Creek Drive South, Vadnais Heights, Ramsey County, Minnesota, 55127, United States
VADNAIS HEIGHTS, MN 551277031
Phone:
Type: Mailing
8990, Springbrook Drive Northwest, Parkside, Coon Rapids, Anoka County, Minnesota, 55433, United States
STE 250
COON RAPIDS, MN 554335850
Phone: (763) 398-0099
Fax: (763) 398-0124
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCS	Description	Services	Beneficiaries	Medicare allowed
01402	Anesthesia for procedure for total knee joint replacement	11	11	$0

View full utilization report →

Insurance plans in this area (ZIP 55127)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 9133491194View full group profile

Name	Specialty	State
CYNTHIA J MARTINSON (CRNA)	-	MN
JUSTIN ROBERT CUSICK (CRNA)	Certified Registered Nurse Anesthetist (Crna)	MN
DEANNA SILICIANO (MD)	-	PA
MICHAEL S KENNEDY (CRNA)	Certified Registered Nurse Anesthetist (Crna)	MN
ADRIENNE BACKUS	Certified Registered Nurse Anesthetist (Crna)	MN
BELINDA VI LEE (M.D.)	A N E S T H E S I O L O G Y	MN
MATTHEW LAYMAN (MD)	A N E S T H E S I O L O G Y	PA
DR. TIMOTHY E LINDSAY (M.D.)	A N E S T H E S I O L O G Y	MN
MRS. DANIELLE PATTI FRANKLIN (CRNA)	-	MN
KATHLEEN ERIN O'MEARA (CRNA)	Certified Registered Nurse Anesthetist (Crna)	WI

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?

The registry entry for Unknown Individual shows NPI 1083616627.

What should I verify if Unknown Individual is listed inactive?

If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.

Is Unknown Individual tied to Vadnais Heights, Minnesota?

If you are local to Vadnais Heights, Minnesota, Unknown Individual may be relevant to your search.

Can I verify credentials using only NPI?

NPI confirms identity in the directory; licensure and board certification require separate checks.