Individual provider Active NPI

Lisa N Von Wald, AGPCNP-BC

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1093147142
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2013006750 Issued in MN
Practice address
500 Harvard St SE
Minneapolis, MN 55455-0363
Phone
(612) 273-3000
NPI assigned
Jul 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R179726-0 MN
Nurse Practitioner 363L00000X 2013006750 MN Primary

Addresses

Primary practice location

500 Harvard St SE
Minneapolis, MN 55455-0363

Mailing address

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 273-3000

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
I20131101000878 MN Practitioner - Nurse Practitioner 1759516503 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Range Regional Health ServicesGroup PAC ID 8022920024, 349 clinicians

Practice addresses (Care Compare)

111 SE 3Rd St
Grand Rapids, MN 55744-3663
Phone (218) 326-3401

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

750 E 34TH St
Hibbing, MN 55746-4600
Phone (218) 262-4881

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Grand Itasca Clinic and Hospital Hospital, Grand Rapids, MN, CCN 240064
  • Range Regional Health Services Hospital, Hibbing, MN, CCN 240040

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R179726-0MNMDRegistered Nurse
2013006750MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Feb 22, 2016 Accepting new patients
Fairview Health Services CurrentSince Aug 31, 2013 Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Aug 20, 2024 Accepting new patients
Fairview Express Care CurrentSince Sep 19, 2020 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Feb 22, 2016 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Jul 1, 2021 Accepting new patients
Fairview Clinics CurrentSince Mar 25, 2021 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Sep 19, 2020 Accepting new patients
Range Regional Health Services CurrentSince Dec 1, 2024 Accepting new patients
Fairview Express Care CurrentSince Aug 31, 2013 Accepting new patients
Range Regional Health Services CurrentSince Dec 1, 2024 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Jul 1, 2021 Accepting new patients
Fairview Clinics CurrentSince Mar 25, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Aug 20, 2024 Accepting new patients

Locations

14101 Fairview Dr
Ste 140
Burnsville, MN 55337

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

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

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

3605 Mayfair Ave
Hibbing, MN 55746
Phone (218) 262-3441

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

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

6405 France Ave S
Ste W200
Minneapolis, MN 55435
Phone (952) 836-3700

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

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

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

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

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

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

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

Interoperability endpoints

  • Direct secure messaging: lvonwald198063@fairview.direct-ci.com

Organizations & group practices 20

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 20

Hospital & facility affiliations 5

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": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1093147142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HARVARD ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550363",
            "telephone_number": "612-273-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HARVARD ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550363",
            "telephone_number": "612-273-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON WALD",
        "first_name": "LISA",
        "middle_name": "N",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R179726-0",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "2013006750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.