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NICOLE THEISEN CRNA
NPI 1164854188
Nurse Anesthetist, Certified Registered in Prior Lake, MN

Active since August 01, 2013PECOS EnrolledAccepts Medicare Assignment
3199 TIMBERWOLF CIR NW, PRIOR LAKE, MN 55372(612) 860-6602 Get Directions Write a Review

NPPES record last updated: January 29, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Nicole Theisen Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE THEISEN CRNA (NPI 1164854188) is an individual nurse anesthetist, certified registered in Prior Lake, Minnesota, licensed in Minnesota (R1718621) and active in the NPI registry since August 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1164854188
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameNICOLE THEISENCredential: CRNA
Location Address3199 TIMBERWOLF CIR NWPrior Lake, MN 55372-3271
Mailing Address3199 Timberwolf Cir NwPrior Lake, MN 55372-3271 · (612) 860-6602
Phone(612) 860-6602
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateAugust 1, 2013
Last NPPES UpdateJanuary 29, 2018
✔ NPI 1164854188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in MN · R1718621
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
3199 TIMBERWOLF CIR NW, Prior Lake, MN 55372
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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

Nicole Theisen 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.

PECOS PAC ID7416182217
PECOS Enrollment IDI20131104000285
Eligible to Order & Refer✔ Part B Labs & Imaging– Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Nicole Theisen reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Minnesota Anesthesia Specialists PLLC
8.7 mi
Anesthesiology
1447 WHITE OAK DR
Chaska, MN 55318
  • Reassigned Medicare billing, Minnesota enrollment
  • 22 clinicians in this Medicare group
NPI 1710693320 (952) 368-3800
Southdale Anesthesiologists, LLC
12 mi
Anesthesiology
6401 FRANCE AVE S
Edina, MN 55435
  • Reassigned Medicare billing, Minnesota enrollment
  • 118 clinicians in this Medicare group
NPI 1154381804 (952) 924-5187
Metropolitan Anesthesia Network, LLP
19 mi
Anesthesiology
14700 28TH AVE N, SUITE 20
Plymouth, MN 55447
  • Reassigned Medicare billing, Minnesota enrollment
  • 1,033 clinicians in this Medicare group
NPI 1558314427 (763) 559-3779

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55372 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Nicole Theisen's NPI number?

The NPI number for Nicole Theisen is 1164854188. It was assigned to this individual provider in the NPPES registry on August 1, 2013.

Where is Nicole Theisen located?

Nicole Theisen practices at 3199 Timberwolf Cir NW, Prior Lake, MN 55372. The listed phone number is (612) 860-6602.

What is Nicole Theisen's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Nicole Theisen enrolled in Medicare?

Yes. Nicole Theisen 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 Nicole Theisen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Theisen reassigns Medicare benefits to 3 organizations: Minnesota Anesthesia Specialists PLLC (Chaska, MN), Southdale Anesthesiologists, LLC (Edina, MN) and Metropolitan Anesthesia Network, LLP (Plymouth, 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 Nicole Theisen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Theisen was last updated on January 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.