Active NPI
Madalena Lou Misura
- Behavior Technician
- Coon Rapids, MN
National Provider Identifier
1205475019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 9120 Springbrook Dr NW
Coon Rapids, MN 55433-5845 - Phone
- (651) 424-4000
- NPI assigned
- Dec 26, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
9120 Springbrook Dr NW
Coon Rapids, MN 55433-5845
Mailing address
2400 W 64TH St
Richfield, MN 55423-1001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fraser Child and Family Center | Current | Accepting new patients | |
| Fraser | Past | Accepting new patients |
Locations
9120 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 231-2590
2400 W 64th St
Richfield, MN 55423
Phone (612) 767-5166
721 Commerce Dr
Woodbury, MN 55125
Phone (651) 424-4000
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.
-
- Adolescent and Children Mental Health Clinic/Center
- Minneapolis, MN
- NPI 1609922194
-
- Rehabilitation Clinic/Center
- Richfield, MN
- NPI 1063568574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581638400000",
"number": "1205475019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 W 64TH ST",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554231001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9120 SPRINGBROOK DR NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554335845",
"telephone_number": "651-424-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISURA",
"first_name": "MADALENA",
"middle_name": "LOU",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-26",
"last_updated": "2020-02-14",
"certification_date": "2020-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.