Individual provider Active NPI

Nicole Racine, LSW

  • Social Worker
  • Saint Paul, MN
National Provider Identifier
1053863993
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
23942 Issued in MN
Practice address
500 Grotto St N
Saint Paul, MN 55104-1754
Phone
(651) 760-3236
Fax
(651) 222-3786
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 23942 MN Primary

Addresses

Primary practice location

500 Grotto St N
Saint Paul, MN 55104-1754

Mailing address

500 Grotto St N
Saint Paul, MN 55104-1754
Phone (651) 760-3236

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231101000698 MN Practitioner - Clinical Social Worker 6204282965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

1540 Lake St S
Forest Lake, MN 55025-2628
Phone (651) 464-7100

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Dec 19, 2023 Accepting new patients
Allina Health System CurrentSince Dec 19, 2023 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

1540 Lake St S
Forest Lake, MN 55025
Phone (651) 464-7100

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

Interoperability endpoints

  • Direct secure messaging: nracine647225@excellian.direct.allina.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1053863993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROTTO ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041754",
            "telephone_number": "651-760-3236",
            "fax_number": "651-222-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GROTTO ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041754",
            "telephone_number": "651-760-3236",
            "fax_number": "651-222-3786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACINE",
        "first_name": "NICOLE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "23942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.