NPIMap

Individual provider Active NPI

Agnieszka S Hatfield, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Coon Rapids, MN
National Provider Identifier
1174637060
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
44333 Issued in MN
Practice address
11850 Blackfoot St NW Ste 130
Coon Rapids, MN 55433-2583
Phone
(763) 236-1900
Fax
(763) 236-9010
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X K2093 TX
Plastic and Reconstructive Surgery Physician 2086S0122X 44333 MN Primary

Addresses

Primary practice location

11850 Blackfoot St NW Ste 130
Coon Rapids, MN 55433-2583

Mailing address

11850 Blackfoot St NW Ste 130
Coon Rapids, MN 55433-2583
Phone (763) 236-1900

Other identifiers 8

IdentifierTypeStateIssuer
180700500MedicaidMN
7581471OtherAETNA
180700500OtherMNMA
1300140OtherMNMEDICA
131146OtherMNUCARE
131MOHAOtherMNBLUE CROSS BLUE SHIELD
C03935OtherMAMEDICARE CORPORATION
92321OtherMNHEALTH PARTNERS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahatfield86997@excellian.direct.allina.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202000659 MN Practitioner - Plastic and Reconstructive Surgery 8123921475 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Utah School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy19
Melanoma (skin cancer) excision19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K2093TXMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Apr 11, 2016 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Apr 11, 2016 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System Past Accepting new patients
Twin Cities Neurosurgery,PLLC Past Accepting new patients

Locations

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

11850 Blackfoot St NW
Ste 300
Minneapolis, MN 55433
Phone (763) 236-0808

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

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

11850 Blackfoot St NW
Ste 130
Minneapolis, MN 55433
Phone (763) 236-2045

Organizations & group practices 6

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 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1174637060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW STE 130",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332583",
            "telephone_number": "763-236-1900",
            "fax_number": "763-236-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW STE 130",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332583",
            "telephone_number": "763-236-1900",
            "fax_number": "763-236-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATFIELD",
        "first_name": "AGNIESZKA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "K2093",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MN",
            "license": "44333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180700500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7581471",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA",
            "identifier": "180700500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1300140",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "131146",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "131MOHA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CORPORATION",
            "identifier": "C03935",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "92321",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahatfield86997@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "11850 Blackfoot St NW Ste 130",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554332583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.