ETHAN PETERSEN CRNA
NPI 1851615108
Nurse Anesthetist, Certified Registered in Saint Cloud, MN
About Ethan Petersen Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN PETERSEN CRNA (NPI 1851615108) is an individual nurse anesthetist, certified registered in Saint Cloud, Minnesota, licensed in Minnesota (R 193342-2) and active in the NPI registry since March 2010. He is enrolled in Medicare PECOS, is affiliated with St Cloud Hospital, and is a graduate of Other (2010).
NPPES Registry Identity
Specialties & Licenses
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
Ethan Petersen 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
5Medicare enrollment records show Ethan Petersen reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Saint Cloud, MN 56303
- Reassigned Medicare billing, Minnesota enrollment
- 1,051 clinicians in this Medicare group
Saint Cloud, MN 56303
- Reassigned Medicare billing, Minnesota enrollment
- 40 clinicians in this Medicare group
Annandale, MN 55302
- Reassigned Medicare billing, Minnesota enrollment
- 3,733 clinicians in this Medicare group
Robbinsdale, MN 55422
- Reassigned Medicare billing, Minnesota enrollment
- 246 clinicians in this Medicare group
Stillwater, MN 55082
- Reassigned Medicare billing, Minnesota enrollment
- 131 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Cloud Hospital
Acute Care Hospitals · Saint Cloud, MNPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 56303 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.
SAINT CLOUD, MN 56303
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 Ethan Petersen's NPI number?
The NPI number for Ethan Petersen is 1851615108. It was assigned to this individual provider in the NPPES registry on March 16, 2010.
Where is Ethan Petersen located?
Ethan Petersen practices at 1406 6th Ave N, Saint Cloud, MN 56303. The listed phone number is (320) 251-2700.
What is Ethan Petersen's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Ethan Petersen enrolled in Medicare?
Yes. Ethan Petersen 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 Ethan Petersen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Petersen reassigns Medicare benefits to 5 organizations: Centracare Clinic (Saint Cloud, MN), St Cloud Outpatient Surgery Ltd (Saint Cloud, MN), Allina Health System (Annandale, MN), Anesthesiology, P.A. (Robbinsdale, MN) and Certified Anesthesia Care, Co. (Stillwater, 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 Ethan Petersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Ethan Petersen affiliated with any hospitals?
According to CMS data, Ethan Petersen is affiliated with St Cloud Hospital.
When was this NPI record last updated?
The NPPES record for Ethan Petersen was last updated on March 16, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Ethan Petersen, CRNA · NPI 1851615108
Nurse Anesthetist, Certified Registered physician in Saint Cloud, Minnesota. Individual provider, active in the CMS NPPES registry since March 16, 2010.
## Identity
- **NPI:** 1851615108 (Entity type: Individual)
- **Enumerated:** March 16, 2010
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** R 193342-2 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 1406 6TH AVE N, Saint Cloud, MN 56303-1900
- **Phone:** (320) 251-2700
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Centracare Clinic (NPI 1538696323, Saint Cloud, MN); St Cloud Outpatient Surgery Ltd (NPI 1124084843, Saint Cloud, MN); Allina Health System (NPI 1457657249, Annandale, MN); Anesthesiology, P.A. (NPI 1013960798, Robbinsdale, MN); Certified Anesthesia Care, Co. (NPI 1699736348, Stillwater, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2010
## Record status
- **NPPES last updated:** March 16, 2010
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Source: [NPI Profile](https://npiprofile.com/npi/1851615108) · Data from the CMS NPPES public registry.