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JENNA STARK
NPI 1386009892
Nurse Anesthetist, Certified Registered in Minneapolis, MN

Active since December 28, 2015PECOS EnrolledAccepts Medicare Assignment
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 365-1000 Get Directions Write a Review

NPPES record last updated: March 19, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 19, 2018, Dec 28, 2015 (2 updates tracked since 2015).

About Jenna Stark NPPES

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

JENNA STARK (NPI 1386009892) is an individual nurse anesthetist, certified registered in Minneapolis, Minnesota, licensed in Minnesota (1866) and active in the NPI registry since December 2015. She is enrolled in Medicare PECOS, is affiliated with M Health Fairview University Of Mn, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1386009892
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameJENNA STARK
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450
Mailing Address18032 70th Pl NMaple Grove, MN 55311-3032 · (320) 309-4780
Phone(612) 365-1000
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateDecember 28, 2015
Last NPPES UpdateMarch 19, 20182 updates tracked since enumeration
✔ NPI 1386009892 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 · 1866
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.
2450 RIVERSIDE AVE, Minneapolis, MN 55454
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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

Jenna Stark 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 ID7416256151
PECOS Enrollment IDI20160429001461
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

8

Medicare enrollment records show Jenna Stark reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Health Services
Same address
General Acute Care Hospital
2450 RIVERSIDE AVE, OUTREACH LAB DEPARTMENT
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 4,038 clinicians in this Medicare group
NPI 1316008212 (612) 273-7838
University Anesthesia Providers, LLC
Same address
Anesthesiology
2450 RIVERSIDE AVE
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 681 clinicians in this Medicare group
NPI 1699711143 (612) 273-3000
Healtheast Medical Research Institute
3.3 mi
Internal Medicine
1700 UNIVERSITY AVE W, 6TH FLOOR WEST
Saint Paul, MN 55104
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,361 clinicians in this Medicare group
NPI 1508191552 (651) 232-2273
Anesthesiology, P.A.
5.3 mi
Anesthesiology
3300 OAKDALE AVE N
Robbinsdale, MN 55422
  • Reassigned Medicare billing, Minnesota enrollment
  • 246 clinicians in this Medicare group
NPI 1013960798 (763) 520-5370
Fairview Maple Grove Surgery Center, LLC
16 mi
Anesthesiology
14500 99TH AVE N STE 500
Maple Grove, MN 55369
  • Reassigned Medicare billing, Minnesota enrollment
  • 226 clinicians in this Medicare group
NPI 1730068032 (855) 324-7843
Central Minnesota Anesthesia Providers, PA
43 mi
Nurse Anesthetist, Certified Registered
14054 BANK ST, BOX 100
Becker, MN 55308
  • Reassigned Medicare billing, Minnesota enrollment
  • 52 clinicians in this Medicare group
NPI 1881689974 (763) 260-8808
St. Joseph's Medical Center
82 mi
Primary Care
138 MAIN ST S
Pierz, MN 56364
  • Reassigned Medicare billing, Minnesota enrollment
  • Medicare enrollment name: St Josephs Medical Center
  • 340 clinicians in this Medicare group
NPI 1568418861 (320) 468-2587
Brainerd Lakes Surgery Center L L C
107 mi
Ambulatory Surgical
13114 ISLE DR
Baxter, MN 56425
  • Reassigned Medicare billing, Minnesota enrollment
  • 21 clinicians in this Medicare group
NPI 1750378295 (218) 822-2400

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

Hospital Affiliations CMS Care Compare 2

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

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

Maple Grove Hospital

Acute Care Hospitals · Maple Grove, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240214
Location9875 Hospital DriveMaple Grove, MN 55369 · Hennepin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55454 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.

MICHELLE IRENE GRAY
Rehabilitation Practitioner
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
DR. KATHLEEN F SADAK MD
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-6402
DR. ADMATHA MUTHYALA WINFRED MD
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
KELLY SCHELLER WILLIAMS
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3216
MRS. MARY SUSAN CLIPP CPNP-AC
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 365-3100
DANIEL TESFAYE KEBED MD
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MS. CHELSEA ANJELICA MIELKE PA-C
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MRS. JESSICA LYNN MCADAM
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-8383

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 Jenna Stark's NPI number?

The NPI number for Jenna Stark is 1386009892. It was assigned to this individual provider in the NPPES registry on December 28, 2015.

Where is Jenna Stark located?

Jenna Stark practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 365-1000.

What is Jenna Stark's specialty?

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

Is Jenna Stark enrolled in Medicare?

Yes. Jenna Stark 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 Jenna Stark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jenna Stark reassigns Medicare benefits to 8 organizations: Fairview Health Services (Minneapolis, MN), University Anesthesia Providers, LLC (Minneapolis, MN), Healtheast Medical Research Institute (Saint Paul, MN), Anesthesiology, P.A. (Robbinsdale, MN), Fairview Maple Grove Surgery Center, LLC (Maple Grove, MN) and 3 more organizations, listed in the Medicare section above. 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 Jenna Stark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jenna Stark affiliated with any hospitals?

According to CMS data, Jenna Stark is affiliated with M Health Fairview University Of Mn and Maple Grove Hospital.

When was this NPI record last updated?

The NPPES record for Jenna Stark was last updated on March 19, 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.