JACKLYN HOLMBERG CRNA
NPI 1316347602
Nurse Anesthetist, Certified Registered in Robbinsdale, MN

Active since August 25, 2014Accepts Medicare Assignment
3300 OAKDALE AVE N, ROBBINSDALE, MN 55422(763) 520-5200(763) 581-0993 Get Directions Write a Review

NPPES record last updated: April 28, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jacklyn Holmberg Crna NPPES

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

JACKLYN HOLMBERG CRNA (NPI 1316347602) is an individual nurse anesthetist, certified registered in Robbinsdale, Minnesota, licensed in Minnesota (1690) and active in the NPI registry since August 2014. She is affiliated with North Memorial Health Hospital and is a graduate of Other (2014).

NPPES Registry Identity

NPI1316347602
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameJACKLYN HOLMBERGCredential: CRNA
Location Address3300 OAKDALE AVE NRobbinsdale, MN 55422-2926
Mailing Address3300 Oakdale Ave NRobbinsdale, MN 55422-2926 · (763) 520-5200 · Fax (763) 581-0993
Fax(763) 581-0993
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateAugust 25, 2014
Last NPPES UpdateApril 28, 2023
NPPES CertifiedApril 28, 2023
NPI 1316347602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License Licensed in MN · 1690
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.

Also ListedRegistered NurseTaxonomy 163W00000X · License R188489-8 (MN)
3300 OAKDALE AVE N, Robbinsdale, MN 55422

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jacklyn Holmberg 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 ID8628394012
PECOS Enrollment IDI20150302001598

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Memorial Health Hospital

Acute Care Hospitals · Robbinsdale, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240001
Location3300 Oakdale NorthRobbinsdale, MN 55422 · Hennepin County
Emergency services Birthing friendly

M Health Fairview University Of Mn

Acute Care Hospitals · Minneapolis, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240080
Location2450 Riverside AvenueMinneapolis, MN 55454 · Hennepin County
Emergency services Birthing friendly

M Health Fairview St John's Hospital

Acute Care Hospitals · Maplewood, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240210
Location1575 Beam AvenueMaplewood, MN 55109 · Ramsey County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55422 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Radiology (Diagnostic Radiology)
3300 OAKDALE AVE N
ROBBINSDALE, MN 55422
Radiology (Diagnostic Radiology)
3300 OAKDALE AVE N
ROBBINSDALE, MN 55422
Radiology (Body Imaging)
3300 OAKDALE AVE N
ROBBINSDALE, MN 55422
Radiology (Diagnostic Radiology)
3300 OAKDALE AVE N
ROBBINSDALE, MN 55422
Radiology (Diagnostic Radiology)
3300 OAKDALE AVE N
ROBBINSDALE, MN 55422
Radiology (Vascular & Interventional Radiology)
3300 OAKDALE AVE N
ROBBINSDALE, MN 55422
Radiology (Diagnostic Radiology)
3300 OAKDALE AVE N
ROBBINSDALE, MN 55422
Radiology (Diagnostic Radiology)
3300 OAKDALE AVE N
ROBBINSDALE, MN 55422

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316347602, enumerated as an "individual" on August 25, 2014.

The provider is located at 3300 OAKDALE AVE N ROBBINSDALE, MN 55422 and the phone number is (763) 520-5200.

Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

The provider might be accepting Accepts: Medica. Please consult your insurance carrier or call the provider to verify.

Jacklyn Holmberg is affiliated with: NORTH MEMORIAL HEALTH HOSPITAL, M HEALTH FAIRVIEW UNIVERSITY OF MN and M HEALTH FAIRVIEW ST JOHN'S HOSPITAL.