Susan K Nelson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39672 Issued in MN

Practice address

5500 Boone Ave N
New Hope, MN 55428-3629

Phone

(701) 793-4444

NPI assigned

Oct 3, 2006

Last updated

Jul 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

University of North Dakota School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cass Lake Indian Health Services Hospital Hospital, Cass Lake, MN, CCN 241358

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Department of Health & Human Services PHS IHS

  • Critical Access Hospital
  • Cass Lake, MN
  • NPI 1194754382

  TX

  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  MN

  Medicare reassignment NPD
• Group Health, Inc.

  dba HealthPartners Midway Residency Dental

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD (past)
• North Ridge Skilled, LLC

  dba North Ridge Health and Rehab

  • Skilled Nursing Facility
  • New Hope, MN
  • NPI 1881689628
  NPD (past)
• Apex Physical Therapy and Wellness Center, PC

  • Physical Therapy Clinic/Center
  • West Fargo, ND
  • NPI 1417109059
  NPD (past)
• St. Francis Medical Center

  dba Chi St Francis Health

  • Rural Health Clinic/Center
  • Milnor, ND
  • NPI 1235215252
  NPD (past)
• Theoria Medical

  dba Theoria Primary Care

  • Internal Medicine Physician
  • Brighton, MI
  • NPI 1164186946

  Family Medicine

  NPD (past)
• Tracie M Mallberg MD PC

  dba LilyCare Clinic

  • Primary Care Clinic/Center
  • West Fargo, ND
  • NPI 1023282969

  Family Medicine

  NPD (past)

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

• Department of Health & Human Services PHS IHS

  • Critical Access Hospital
  • Cass Lake, MN
  • NPI 1194754382
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1174617732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40016 EDISON DR NE",
            "city": "STANCHFIELD",
            "state": "MN",
            "postal_code": "550803232",
            "telephone_number": "701-793-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 BOONE AVE N",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554283629",
            "telephone_number": "701-793-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "39672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174617732",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alethia Moua, LICSW
• Ellina Andreyevna Mudraya, PTA
• Heather A. Muras, MA, LMFT
• Mya Home Care LLC
• Nedkacare LLC
• New Hope Alf Operator LLC
• New Hope Dialysis LLC (New Hope Dialysis Center)
• New Hope Operator LLC
• New Life Global LLC (New Life Health Service)
• Newhope Dental PA

• Family Medicine Physician in New Hope, MN
• Providers in New Hope, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.