Active NPI
Pang Vang, DNP, APRN, CNP
- Family Nurse Practitioner
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F12210545
- Practice address
- 525 Portland Ave. FL 4 Mc952
Minneapolis, MN 55415-1533 - Phone
- (612) 543-5555
- NPI assigned
- Jan 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F12210545 | MN | Primary |
Addresses
Primary practice location
525 Portland Ave. FL 4 Mc952
Minneapolis, MN 55415-1533
Mailing address
525 Portland Ave. FL 4 Mc952
Minneapolis, MN 55415-1533
Phone (612) 543-5555
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | malwarebytes |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
525 Portland Ave S MC
Suite 952
Minneapolis, MN 55415-1569
Phone (612) 543-5555
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F12210545 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gillette Children'S Specialty Healthcare | Current | Accepting new patients | |
| Gillette Children'S Specialty Healthcare | Current | Accepting new patients | |
| Hennepin County | Current | Accepting new patients | |
| Hennepin County | Current | Accepting new patients | |
| Hennepin County | Current | Accepting new patients | |
| Hennepin County | Past | Accepting new patients |
Locations
525 Portland Ave
Fl 4
Minneapolis, MN 55415
Phone (612) 348-9840
9600 Aldrich Ave S
#658
Minneapolis, MN 55420
525 Portland Ave
Minneapolis, MN 55415
Phone (612) 348-8824
435 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200
200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848
Organizations & group practices 6
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.
-
dba Hennepin County Mental Health Center
- Psychiatry Physician
- Minneapolis, MN
- NPI 1780790345
-
dba Gillette Children's Professional Services
- Multi-Specialty Clinic/Center
- St. Paul, MN
- NPI 1225119175
-
- Multi-Specialty Clinic/Center
- Saint Cloud, MN
- NPI 1982090528
-
dba NorthPoint Health & Wellness Center - Workforce Center Medical
- Community Health Clinic/Center
- Minneapolis, MN
- NPI 1154774925
-
dba Endeavors
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1962147413
-
dba Public Health Clinic
- Public Health or Welfare Agency
- Minneapolis, MN
- NPI 1295812386
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713484800000",
"number": "1073265328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 PORTLAND AVE. FL 4 MC952",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151533",
"telephone_number": "612-543-5555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 PORTLAND AVE. FL 4 MC952",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151533",
"telephone_number": "612-543-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANG",
"first_name": "PANG",
"credential": "DNP, APRN, CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-18",
"last_updated": "2024-04-19",
"certification_date": "2024-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "F12210545",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "malwarebytes",
"affiliation": "N",
"address_1": "525 Portland Ave. Fl 4 MC952",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554151533",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.