AMANDA JOAN PETERSEN APRN/CRNA
NPI 1063983724
Nurse Anesthetist, Certified Registered in Duluth, MN
About Amanda Joan Petersen Aprn/crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AMANDA JOAN PETERSEN APRN/CRNA (NPI 1063983724) is an individual nurse anesthetist, certified registered in Duluth, Minnesota, licensed in Minnesota (CRNA2273) and active in the NPI registry since December 2018. She is enrolled in Medicare PECOS, is affiliated with Essentia Health St Joseph's Medical Center, and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Amanda Joan Petersen Aprn/crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Amanda Petersen reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Duluth, MN 55805
- Reassigned Medicare billing, Minnesota and Wisconsin enrollments
- 1,460 clinicians in this Medicare group
Deerwood, MN 56444
- Reassigned Medicare billing, Minnesota enrollment
- Medicare enrollment name: St Josephs Medical Center
- 340 clinicians in this Medicare group
Baxter, MN 56425
- Reassigned Medicare billing, Minnesota enrollment
- 21 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Essentia Health St Joseph's Medical Center
Acute Care Hospitals · Brainerd, MNPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DULUTH, MN 55805
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Amanda Petersen's NPI number?
The NPI number for Amanda Petersen is 1063983724. It was assigned to this individual provider in the NPPES registry on December 6, 2018.
Where is Amanda Petersen located?
Amanda Petersen practices at Duluth Clinic 400 East Third Street, Duluth, MN 55805. The listed phone number is (218) 786-8364.
What is Amanda Petersen's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Amanda Petersen enrolled in Medicare?
Yes. Amanda Petersen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Amanda Petersen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Petersen reassigns Medicare benefits to 3 organizations: The Duluth Clinic, Ltd (Duluth, MN), St Joseph's Medical Center (Deerwood, MN) and Brainerd Lakes Surgery Center L L C (Baxter, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Amanda Petersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Amanda Petersen affiliated with any hospitals?
According to CMS data, Amanda Petersen is affiliated with Essentia Health St Joseph's Medical Center.
When was this NPI record last updated?
The NPPES record for Amanda Petersen was last updated on December 31, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Amanda Joan Petersen, APRN/CRNA · NPI 1063983724
Nurse Anesthetist, Certified Registered physician in Duluth, Minnesota. Individual provider, active in the CMS NPPES registry since December 6, 2018.
## Identity
- **NPI:** 1063983724 (Entity type: Individual)
- **Enumerated:** December 6, 2018
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** CRNA2273 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** DULUTH CLINIC, 400 EAST THIRD STREET, Duluth, MN 55805-1951
- **Phone:** (218) 786-8364
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): The Duluth Clinic, Ltd (NPI 1245278209, Duluth, MN); St Joseph's Medical Center (NPI 1033814066, Deerwood, MN); Brainerd Lakes Surgery Center L L C (NPI 1750378295, Baxter, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** December 31, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1063983724) · Data from the CMS NPPES public registry.