Individual provider Active NPI

Gage O'Neal

  • Clinical Social Worker
  • Minnetonka, MN
National Provider Identifier
1053193342
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
13100 Wayzata Blvd Ste 200
Minnetonka, MN 55305-1810
Phone
(952) 206-2040
NPI assigned
Oct 20, 2023
Last updated
Oct 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MN Primary

Addresses

Primary practice location

13100 Wayzata Blvd Ste 200
Minnetonka, MN 55305-1810

Mailing address

255 Shelard Pkwy Apt 112
St Louis Park, MN 55426-4909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD Clinical CurrentSince Oct 22, 2023 Accepting new patients

Locations

13100 Wayzata Blvd
Ste 200
Minnetonka, MN 55305
Phone (952) 206-2040

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1053193342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 SHELARD PKWY APT 112",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 WAYZATA BLVD STE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051810",
            "telephone_number": "952-206-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "GAGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.