KENDALL PETTY CRNA
NPI 1720287154
Nurse Anesthetist, Certified Registered in Coon Rapids, MN
About Kendall Petty Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENDALL PETTY CRNA (NPI 1720287154) is an individual nurse anesthetist, certified registered in Coon Rapids, Minnesota, licensed in Minnesota (R 135220-7) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Abbott Northwestern Hospital, and is a graduate of University Of Minnesota Medical School (2007).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
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
Kendall Petty 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
2Medicare enrollment records show Kendall Petty reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Coon Rapids, MN 55433
- Reassigned Medicare billing, Minnesota enrollment
- 3,733 clinicians in this Medicare group
Plymouth, MN 55447
- Reassigned Medicare billing, Minnesota enrollment
- 1,033 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 2
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.
Abbott Northwestern Hospital
Acute Care Hospitals · Minneapolis, MNPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55433 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
COON RAPIDS, MN 55433
COON RAPIDS, MN 55433
COON RAPIDS, MN 55433
COON RAPIDS, MN 55433
COON RAPIDS, MN 55433
COON RAPIDS, MN 55433
COON RAPIDS, MN 55433
COON RAPIDS, MN 55433
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 Kendall Petty's NPI number?
The NPI number for Kendall Petty is 1720287154. It was assigned to this individual provider in the NPPES registry on July 16, 2007.
Where is Kendall Petty located?
Kendall Petty practices at 8990 Springbrook Dr NW Suite 250, Coon Rapids, MN 55433. The listed phone number is (763) 398-0099.
What is Kendall Petty's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Kendall Petty enrolled in Medicare?
Yes. Kendall Petty 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 Kendall Petty's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kendall Petty reassigns Medicare benefits to 2 organizations: Allina Health System (Coon Rapids, 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 Kendall Petty's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Kendall Petty affiliated with any hospitals?
According to CMS data, Kendall Petty is affiliated with Abbott Northwestern Hospital.
When was this NPI record last updated?
The NPPES record for Kendall Petty was last updated on May 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Kendall Petty, CRNA · NPI 1720287154
Nurse Anesthetist, Certified Registered physician in Coon Rapids, Minnesota. Individual provider, active in the CMS NPPES registry since July 16, 2007.
## Identity
- **NPI:** 1720287154 (Entity type: Individual)
- **Enumerated:** July 16, 2007
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** R 135220-7 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 8990 SPRINGBROOK DR NW, SUITE 250, Coon Rapids, MN 55433-5850
- **Phone:** (763) 398-0099 · **Fax:** (763) 398-0124
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Allina Health System (NPI 1295031649, Coon Rapids, MN); Metropolitan Anesthesia Network, LLP (NPI 1558314427, Plymouth, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Minnesota Medical School, class of 2007
## Record status
- **NPPES last updated:** May 19, 2008
- **Other identifiers:** Medicaid 430917000 (MN); Medicare PIN 430006044 (MN); Other 53L81PE (MN)
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Source: [NPI Profile](https://npiprofile.com/npi/1720287154) · Data from the CMS NPPES public registry.