Northstar Sleep Center LLC

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

NORTHSTAR SLEEP CENTER LLC

Practice address

3800 Coon Rapids Blvd NW
Suite 3800
Coon Rapids, MN 55433

Phone

(952) 567-7400

NPI assigned

Jul 5, 2011

Last updated

Aug 6, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debra Jane Mayer

Title

B.O. Manager

Phone

(529) 852-5284

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Allina Health System

  dba Allina Health Brooklyn Park Clinic

  • Clinic/Center
  • Brooklyn Park, MN
  • NPI 1841596293

  Member Of

  NPD member
• Minnesota Lung Center LTD

  • Pulmonary Disease Physician
  • Minneapolis, MN
  • NPI 1184655813

  Member Of

  NPD member

Locations

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joan MK Fox, M.D.

  • Pulmonary Disease Physician
  • Minneapolis, MN
  • NPI 1679593925
  Medicare reassignment NPD
• Charles Owen Gensmer, M.D.

  • Pulmonary Disease Physician
  • Coon Rapids, MN
  • NPI 1356497150
  Medicare reassignment NPD
• Kevin Rene Grullon, M.D.

  • Pulmonary Disease Physician
  • Minneapolis, MN
  • NPI 1295976645
  Medicare reassignment NPD
• Erin Elizabeth Peterson, RN, NP-C

  • Nurse Practitioner
  • St Louis Park, MN
  • NPI 1447560305
  Medicare reassignment NPD
• Kelsey Therese Sharma, APRN, CNP

  • Family Nurse Practitioner
  • Minneapolis, MN
  • NPI 1932761020
  Medicare reassignment NPD
• Angela Kathleen Smaciarz, NP

  • Adult Health Nurse Practitioner
  • Coon Rapids, MN
  • NPI 1346631280
  Medicare reassignment NPD
• Ralph E Steele, M.D.

  • Pulmonary Disease Physician
  • Minneapolis, MN
  • NPI 1477573723
  Medicare reassignment NPD
• Andrew James Stiehm, MD

  • Pulmonary Disease Physician
  • Saint Paul, MN
  • NPI 1164463105
  Medicare reassignment NPD
• Patrick J Wright, M.D.

  • Pulmonary Disease Physician
  • Minneapolis, MN
  • NPI 1811917164
  Medicare reassignment NPD
• Sarah Anne Bolstad, PAC

  • Medical Physician Assistant
  • Minneapolis, MN
  • NPI 1558323352
  Medicare reassignment
• Vanessa Lange, PA-C

  • Physician Assistant
  • Maple Grove, MN
  • NPI 1407307077
  Medicare reassignment
• Hannah Warkel, PA-C

  • Physician Assistant
  • Minneapolis, MN
  • NPI 1851848113
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533513600000",
    "number": "1124315700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E 28TH ST",
            "address_2": "SUITE 700",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 COON RAPIDS BLVD NW",
            "address_2": "SUITE 3800",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "55433",
            "telephone_number": "952-567-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR SLEEP CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-05",
        "last_updated": "2018-08-06",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "B.O. MANAGER",
        "authorized_official_telephone_number": "529-852-5284"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sleep Disorder Diagnostic Clinic/Center in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Sleep Disorder Diagnostic Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.