Active NPI
Gillian Hackedorn Luscri, M.D.
- Pediatrics Physician
- Burnsville, MN
National Provider Identifier
1245407097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 54068
- Practice address
- 14000 Fairview Dr
Burnsville, MN 55337-5713 - Phone
- (952) 993-8682
- NPI assigned
- May 12, 2008
- Last updated
- Jun 7, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 54068 | MN | Primary |
Addresses
Primary practice location
14000 Fairview Dr
Burnsville, MN 55337-5713
Mailing address
9887 Jedlicka CT
Eden Prairie, MN 55347-4227
Phone (612) 751-2447
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Pediatrics | Current | Accepting new patients |
| Park Nicollet Clinic | Pediatrics | Current | Accepting new patients |
| Fairview Health Services | Past | Accepting new patients |
Locations
14000 Fairview Dr
Burnsville, MN 55337
Phone (952) 993-8608
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
Interoperability endpoints
- gluscri68981@direct.healthpartners.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Fairview Ridges Hospital
- General Acute Care Hospital
- Burnsville, MN
- NPI 1245217520
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370563200000",
"number": "1245407097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9887 JEDLICKA CT",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553474227",
"telephone_number": "612-751-2447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14000 FAIRVIEW DR",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553375713",
"telephone_number": "952-993-8682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUSCRI",
"first_name": "GILLIAN",
"middle_name": "HACKEDORN",
"name_prefix": "Mrs.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-12",
"last_updated": "2013-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "54068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.