Individual provider Active NPI

Lucy Kapustka

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1093582413
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3333 University Ave SE
Minneapolis, MN 55414-3325
Phone
(612) 767-7222
NPI assigned
Dec 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

3333 University Ave SE
Minneapolis, MN 55414-3325

Mailing address

3260 78TH St E
Inver Grove Heights, MN 55076-3032
Phone (414) 712-3765

Other practice location 1

450 Syndicate St N
Saint Paul, MN 55104-4107
Phone (612) 767-7222

Other names 1

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111001270 MN Practitioner - Clinical Social Worker 0345691630 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30217MNMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Child and Family Center CurrentSince Dec 1, 2023 Accepting new patients

Locations

9120 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 231-2590

3333 University Ave SE
Minneapolis, MN 55414
Phone (612) 253-1139

2400 W 64th St
Richfield, MN 55423
Phone (612) 767-5166

Organizations & group practices 1

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": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1093582413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 78TH ST E",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550763032",
            "telephone_number": "414-712-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 UNIVERSITY AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143325",
            "telephone_number": "612-767-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Syndicate St N",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551044107",
            "country_code": "US",
            "telephone_number": "612-767-7222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAPUSTKA",
        "first_name": "LUCY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-06",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCY",
            "last_name": "KASTONEK",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.