Mrs Kelly Rae Peterson, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Maple Grove, MN

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Mrs Kelly Rae Peterson, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Maple Grove, Minnesota. She graduated from nursing school in 2011 and has 13 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Metropolitan Anesthesia Network Llp, Ridgeview Medical Center and her current practice location is 9803 Vagabond Ln N, Maple Grove, Minnesota. You can reach out to her office (for appointments etc.) via phone at (612) 242-1341.

Mrs Kelly Rae Peterson is licensed to practice in Minnesota (license number 88989) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1336424027.

Contact Information

Mrs Kelly Rae Peterson, CRNA
9803 Vagabond Ln N,
Maple Grove, MN 55311-1364
(612) 242-1341
Not Available

Map and Direction




Provider's Profile

Full NameMrs Kelly Rae Peterson
GenderFemale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience13 Years
Location9803 Vagabond Ln N, Maple Grove, Minnesota
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mrs Kelly Rae Peterson graduated from nursing school in 2011
  NPI Data:
  • NPI Number: 1336424027
  • Provider Enumeration Date: 10/13/2011
  • Last Update Date: 01/26/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 9931375557
  • Enrollment ID: I20120104000059

Medical Identifiers

Medical identifiers for Mrs Kelly Rae Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1336424027NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 88989 (Minnesota)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Ridgeview Medical CenterWaconia, MNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Metropolitan Anesthesia Network Llp5698689123647
Ridgeview Medical Center9234041997193

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Kelly Rae Peterson allows following entities to bill medicare on her behalf.
Entity NameFairview Health Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013994359
PECOS PAC ID: 1951213057
Enrollment ID: O20031105000461
Entity NameRidgeview Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1528364429
PECOS PAC ID: 9234041997
Enrollment ID: O20031111000183
Entity NameMetropolitan Anesthesia Network Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558314427
PECOS PAC ID: 5698689123
Enrollment ID: O20031118000579
Entity NameUniversity Anesthesia Providers Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1699711143
PECOS PAC ID: 7315986064
Enrollment ID: O20050502000881

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kelly Rae Peterson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Kelly Rae Peterson, CRNA
9803 Vagabond Ln N,
Maple Grove, MN 55311-1364

Ph: (612) 242-1341		Mrs Kelly Rae Peterson, CRNA
9803 Vagabond Ln N,
Maple Grove, MN 55311-1364

Ph: (612) 242-1341

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Maple Grove, MN

Kayla Jane Runkle,
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 9875 Hospital Dr, Maple Grove, MN 55369
Phone: 763-581-1000    Fax: 763-450-3986
Jeffrey Merriam, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 9645 Grove Cir N Ste 250, Maple Grove, MN 55369
Phone: 763-201-8191    Fax: 763-201-8192
Gregory S Mellesmoen, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 9645 Grove Cir N Ste 250, Maple Grove, MN 55369
Phone: 763-201-8191    Fax: 763-201-8192

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.