NPIMap

Individual provider Active NPI

Miteku Desalgne, NP

  • Family Nurse Practitioner
  • Hastings, MN
National Provider Identifier
1164028296
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8215 Issued in MN
Practice address
1880 N Frontage Rd
Hastings, MN 55033-2687
Phone
(651) 438-1800
Fax
(651) 438-1837
NPI assigned
Dec 4, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8215 MN Primary
Family Nurse Practitioner 363LF0000X 209022406 IL

Addresses

Primary practice location

1880 N Frontage Rd
Hastings, MN 55033-2687

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other practice location 1

11995 County Rd 11
Suite 220
Burnsville, MN 55337-2177
Phone (773) 653-9790

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdesalgne663102@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220824001667 MN Practitioner - Nurse Practitioner 8820471899 Reassigns benefits to 2 organizations
I20220915002253 IL Practitioner - Nurse Practitioner 8820471899

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

1880 N Frontage Rd
Hastings, MN 55033-2687
Phone (651) 438-1800

Hospital & facility affiliations

  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209022406ILMDFamily Nurse Practitioner
8215MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jul 29, 2024 Accepting new patients
Allina Health System Current Accepting new patients
Lakeshore Community Services CurrentSince Aug 11, 2022 Accepting new patients
Allina Health System CurrentSince Jul 29, 2024 Accepting new patients
Wellnest Corporation CurrentSince Jun 25, 2023 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

1880 N Frontage Rd
Hastings, MN 55033
Phone (651) 438-1800

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

Interoperability endpoints

  • Direct secure messaging: mdesalgne663102@excellian.direct.allina.com

Organizations & group practices 5

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1164028296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 N FRONTAGE RD",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550332687",
            "telephone_number": "651-438-1800",
            "fax_number": "651-438-1837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11995 County Rd 11",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553372177",
            "country_code": "US",
            "telephone_number": "773-653-9790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESALGNE",
        "first_name": "MITEKU",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-04",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8215",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdesalgne663102@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1880 N Frontage Rd",
            "city": "Hastings",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550332687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hastings, MN

Sources for this page

Verify at the official NPI Registry.