Individual provider Active NPI

Ryan Zinken

  • Psychiatric/Mental Health Nurse Practitioner
  • New Brighton, MN
National Provider Identifier
1093262065
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R 190379-5 Issued in MN
Practice address
1900 Silver Lake Road,
Suite 110
New Brighton, MN 55112
Phone
(651) 746-2392
NPI assigned
Sep 7, 2016
Last updated
Sep 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R 190379-5 MN Primary

Addresses

Primary practice location

1900 Silver Lake Road,
Suite 110
New Brighton, MN 55112

Mailing address

217 8TH Ave S
Sauk Rapids, MN 56379-1839

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
I20160930000958 MN Practitioner - Nurse Practitioner 9830486133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Horizon Psychiatry LLCGroup PAC ID 7214214584, 6 clinicians

Practice addresses (Care Compare)

21370 John Milless Dr
Suite 210
Rogers, MN 55374-4622
Phone (763) 428-2288

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 190379-5MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Psychiatry, LLC CurrentSince May 1, 2017 Accepting new patients
Nystrom & Associates, LTD CurrentSince Oct 3, 2016 Accepting new patients
Family Support Services Inc. PastSince Jan 1, 2024 Accepting new patients

Locations

9245 Quantrelle Ave NE
Otsego, MN 55330
Phone (763) 308-8619

21370 John Milless Dr
Ste 210
Rogers, MN 55374
Phone (763) 428-2288

2848 2nd St S
Ste 135
Saint Cloud, MN 56301
Phone (763) 428-2288

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

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, 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": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1093262065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 8TH AVE S",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE ROAD,",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "651-746-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZINKEN",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R 190379-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brighton, MN

Sources for this page

Verify at the official NPI Registry.