Individual provider Active NPI

Melissa M. J. Baumgart, APRN-BC

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1205020005
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R122944-0 Issued in MN
Practice address
700 Raymond Ave Ste 130
Saint Paul, MN 55114-1778
Phone
(612) 895-1510
Fax
(833) 979-0945
NPI assigned
Sep 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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 R122944-0 MN Primary

Addresses

Primary practice location

700 Raymond Ave Ste 130
Saint Paul, MN 55114-1778

Mailing address

2196 White Bear Ave N
Maplewood, MN 55109-2708
Phone (516) 704-0322

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
I20071022000417 MN Practitioner - Nurse Practitioner 1658467675 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
826MNMDFoot & Ankle Surgery Podiatrist
R122944-0MNMDFamily Nurse Practitioner

Practice roles (1 of 5)

OrganizationSpecialtyStatusNew patients
Recovery Telecare LLC Family CurrentSince Mar 4, 2025 Accepting new patients

Locations

724 Bielenberg Dr
Woodbury, MN 55125
Phone (612) 708-1676

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: melissa.baumgart@292123710390276.direct.elationemr.com

Organizations & group practices 1

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": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1205020005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2196 WHITE BEAR AVE N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092708",
            "telephone_number": "516-704-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RAYMOND AVE STE 130",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141778",
            "telephone_number": "612-895-1510",
            "fax_number": "833-979-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGART",
        "first_name": "MELISSA",
        "middle_name": "M. J.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R122944-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.