Individual provider Active NPI

Amy J Rongstad, F.N.P.

  • Family Nurse Practitioner
  • Montevideo, MN
National Provider Identifier
1194723486
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R132176-2 Issued in MN
Practice address
824 N 11TH St
Montevideo, MN 56265-1629
Phone
(320) 269-8877
Fax
(320) 320-8200
NPI assigned
Jul 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R132176-2 MN Primary

Addresses

Primary practice location

824 N 11TH St
Montevideo, MN 56265-1629

Mailing address

824 N 11TH St
Montevideo, MN 56265-1629
Phone (320) 269-8877

Other identifiers 1

IdentifierTypeStateIssuer
772668600MedicaidMN

Other names 1

  • Amy J. Welberg Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address arongstad427897@direct.centracare.com

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
I20040517001319 MN Practitioner - Nurse Practitioner 3870583198 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
CCM HealthGroup PAC ID 4284539453, 69 clinicians

Practice addresses (Care Compare)

824 N 11TH St
Montevideo, MN 56265-1629
Phone (320) 269-8877

Hospital & facility affiliations

  • Chippewa County Hospital Hospital, Montevideo, MN, CCN 241325

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as group
Quality
96.66
Promoting interoperability
100
Improvement activities
40
Cost
67.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R132176-2MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CCM Health CurrentSince Apr 13, 2011 Accepting new patients
CCM Health CurrentSince Apr 13, 2011 Accepting new patients
CCM Health Past Accepting new patients

Locations

824 N 11th St
Montevideo, MN 56265
Phone (320) 269-8877

Interoperability endpoints

  • Direct secure messaging: arongstad427897@direct.centracare.com

Organizations & group practices 3

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1194723486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 N 11TH ST",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651629",
            "telephone_number": "320-269-8877",
            "fax_number": "320-269-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 N 11TH ST",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651629",
            "telephone_number": "320-269-8877",
            "fax_number": "320-320-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONGSTAD",
        "first_name": "AMY",
        "middle_name": "J",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R132176-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "772668600",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arongstad427897@direct.centracare.com",
            "affiliation": "N",
            "address_1": "824 N 11th St",
            "city": "Montevideo",
            "state": "MN",
            "country_code": "US",
            "postal_code": "562651629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "WELBERG",
            "middle_name": "J.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montevideo, MN

Sources for this page

Verify at the official NPI Registry.