JEFFREY R JOHANNSEN CRNA
NPI 1730125816
Nurse Anesthetist, Certified Registered in Detroit Lakes, MN

Q: What is Jeffrey Johannsen's NPI number?

The NPI number for Jeffrey Johannsen is 1730125816. It was assigned to this individual provider in the NPPES registry on June 20, 2006.

Q: What is Jeffrey Johannsen's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jeffrey Johannsen was last updated on July 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since June 20, 2006PECOS EnrolledAccepts Medicare Assignment

1027 WASHINGTON AVE, DETROIT LAKES, MN 56501(218) 847-5611(218) 847-0881 Get Directions Write a Review

NPPES record last updated: July 19, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Jeffrey R Johannsen Crna NPPES

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

JEFFREY R JOHANNSEN CRNA (NPI 1730125816) is an individual nurse anesthetist, certified registered in Detroit Lakes, Minnesota, licensed in Minnesota (R141280-4) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Essentia Health St Marys - Detroit Lakes, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1730125816

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameJEFFREY R JOHANNSENCredential: CRNA

Location Address1027 WASHINGTON AVEDetroit Lakes, MN 56501-3409

Mailing Address1027 Washington AveDetroit Lakes, MN 56501-3409 · (218) 847-5611 · Fax (218) 847-0881

Phone(218) 847-5611

Fax(218) 847-0881

Sole ProprietorNo

Medical School CMSOtherGraduated 2002

Enumeration DateJune 20, 2006

Last NPPES UpdateJuly 19, 2012

✔ NPI 1730125816 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 · R141280-4

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.

1027 WASHINGTON AVE, Detroit Lakes, MN 56501

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Other Identifiers 12

Medicaid150582300MN

Medicare PIN430006211MN

OtherHP38479MN · Healthpartners #

Other1697627MN · America's Ppo/araz #

Medicare ID-Type UnspecifiedP00103457MN · Rr Medicare #

Other2001891MN · Medica #

OtherDA9031034432MN · Preferred One #

Medicaid1730125816MN

Other033G2JOMN · Mnbs #

Other24174MN · Lhs/bannerhealth #

Other23758MN · Ndbs #

Medicaid12694MN

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

Jeffrey R Johannsen 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 ID7416853981

PECOS Enrollment IDI20031208000578

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 Reassignment

Medicare enrollment records show Jeffrey Johannsen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Mary's Regional Health Center

Same address

Medicare Defined Swing Bed Unit

1027 WASHINGTON AVE
Detroit Lakes, MN 56501

Reassigned Medicare billing, Minnesota enrollment
Medicare enrollment name: St Marys Regional Health Center
254 clinicians in this Medicare group

NPI 1134118250 (218) 847-5611

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 4

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.

Anesthesia for lens surgery 00142

Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.

16 services13 patients

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731

This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.

14 services14 patients

Anesthesia for other procedure on large bowel using an endoscope 00811

Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.

14 services14 patients

Anesthesia for exam of colon using an endoscope 00812

Anesthesia for a colon examination with an endoscope is a method used to ensure comfort during the procedure. It involves administering medication to help you relax or sleep, thus reducing discomfort as the endoscope, a thin, flexible tube, is navigated through your colon.

14 services14 patients

Hospital Affiliations CMS Care Compare

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

Essentia Health St Marys - Detroit Lakes

Acute Care Hospitals · Detroit Lakes, MN

OwnershipVoluntary non-profit - Church

CMS Certification Number240101

Location1027 Washington AveDetroit Lakes, MN 56501 · Becker County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56501 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.

MELISSA M HOFFMAN

Occupational Therapist