Individual provider Active NPI

Mary Patricia McCarthy Osborne, CNP

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1093400715
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
10112 Issued in MN
Practice address
2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone
(612) 365-1000
NPI assigned
Apr 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 10112 MN Primary

Addresses

Primary practice location

2450 Riverside Ave
Minneapolis, MN 55454-1450

Mailing address

1072 Shryer Ave W
Roseville, MN 55113-6442
Phone (651) 442-7340

Other names 1

  • Mary Patricia McCarthy Former name

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
I20230502002653 MN Practitioner - Nurse Practitioner 7416312194 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jun 18, 2023 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jun 18, 2023 Accepting new patients
Fairview Express Care CurrentSince Jun 18, 2023 Accepting new patients
University of Minnesota Physicians CurrentSince Jun 18, 2023 Accepting new patients
University of Minnesota Physicians CurrentSince Jun 18, 2023 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jun 18, 2023 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

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

2512 S 7th St
Minneapolis, MN 55454
Phone (612) 273-4277

2450 Riverside Ave
Fl 9
Minneapolis, MN 55454
Phone (612) 365-8100

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

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

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

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

Organizations & group practices 9

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": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1093400715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 SHRYER AVE W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551136442",
            "telephone_number": "651-442-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-365-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "MARY",
        "middle_name": "PATRICIA MCCARTHY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "10112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MCCARTHY",
            "middle_name": "PATRICIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.