Individual provider Active NPI

Theresa M Hoffoss, WHCNP

  • Women's Health Nurse Practitioner
  • Maplewood, MN
National Provider Identifier
1174593990
Registry record updated Feb 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
R161997-9 Issued in MN
Practice address
2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone
(651) 600-3035
Fax
(651) 348-8783
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R161997-9 MN Primary

Addresses

Primary practice location

2603 White Bear Ave N
Maplewood, MN 55109-5110

Mailing address

5124 39TH Ave S
Minneapolis, MN 55417-1652

Other identifiers 1

IdentifierTypeStateIssuer
966496300MedicaidMN

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
I20050607000042 MN Practitioner - Nurse Practitioner 9032152475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minnesota Womens Care PAGroup PAC ID 9638329394, 44 clinicians

Practice addresses (Care Compare)

2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone (651) 600-3035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R161997-9MNMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Women'S Care, P.a. CurrentSince Dec 1, 2017 Accepting new patients
Hennepin County Past Accepting new patients

Locations

2603 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 209-8125

1687 Woodlane Dr
Woodbury, MN 55125
Phone (651) 209-6685

1687 Woodlane Dr
Ste 101
Woodbury, MN 55125
Phone (651) 209-6263

86 Coulee Rd
Ste 201
Hudson, WI 54016
Phone (715) 386-2424

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FAHCDA
  • Direct secure messaging: theresa.hoffoss@mwc.eclinicaldirectplus.com

Organizations & group practices 2

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518652800000",
    "number": "1174593990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5124 39TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 WHITE BEAR AVE N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095110",
            "telephone_number": "651-600-3035",
            "fax_number": "651-348-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFOSS",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "WHCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2018-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "R161997-9",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "966496300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.