Individual provider Active NPI

Susan Marie Johnson, APRN, CNP

  • Adult Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1023253945
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2357 Issued in MN
Practice address
715 S 8TH Street
Minneapolis, MN 55404-1210
Phone
(612) 873-6963
NPI assigned
Dec 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2357 MN
Acute Care Nurse Practitioner 363LA2100X 2357 MN
Gerontology Nurse Practitioner 363LG0600X 2357 MN
Adult Health Nurse Practitioner 363LA2200X 2357 MN Primary

Addresses

Primary practice location

715 S 8TH Street
Minneapolis, MN 55404-1210

Mailing address

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000

Other practice location 1

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-2300

Other names 1

  • Susan Marie Johnson-Sickel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090224000597 MN Practitioner - Nurse Practitioner 6608931753 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians

Practice addresses (Care Compare)

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963

790 W 66TH St
Richfield, MN 55423-2203
Phone (612) 873-6963

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
74.5
Promoting interoperability
100
Improvement activities
40
Cost
72.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2357MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin Healthcare System, Inc Current Accepting new patients
Fairview Clinics Current Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Nov 9, 2022 Accepting new patients
Fairview Express Care CurrentSince May 20, 2021 Accepting new patients
Fairview Health Services CurrentSince May 20, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Aug 24, 2021 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince May 20, 2021 Accepting new patients
Fairview Express Care CurrentSince May 20, 2021 Accepting new patients
Fairview Clinics CurrentSince May 20, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Aug 24, 2021 Accepting new patients
Fairview Clinics CurrentSince May 20, 2021 Accepting new patients
Hennepin Faculty Associates Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

600 W 98th St
Minneapolis, MN 55420
Phone (952) 881-2651

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

715 S 8th St
Minneapolis, MN 55404
Phone (612) 873-6010

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 16

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1023253945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S 8TH STREET",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554041210",
            "telephone_number": "612-873-6963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-2300",
            "fax_number": "612-904-4261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-05",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "2357",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MN",
            "license": "2357",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "2357",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "2357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "JOHNSON-SICKEL",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.