Active NPI
Amanda J Mickelson, CNP
- Gerontology Nurse Practitioner
- Oak Park Heights, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 5658
- Practice address
- 5715 Memorial Ave N
Oak Park Heights, MN 55082-1093 - Phone
- (651) 439-8807
- Fax
- (651) 439-0232
- NPI assigned
- Nov 29, 2017
- Last updated
- Jun 17, 2026
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 5658 | MN | Primary |
| Gerontology Nurse Practitioner | 363LG0600X | 10032-33 | WI |
Addresses
Primary practice location
5715 Memorial Ave N
Oak Park Heights, MN 55082-1093
Mailing address
3500 American Blvd W Ste 300
Bloomington, MN 55431-4442
Phone (952) 512-5600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5715 Memorial Ave N
Oak Park Heights, MN 55082-1093
Phone (651) 439-8807
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.79 of 100
- Quality
- 95.08
- Improvement activities
- 40
- Cost
- 81.67
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5658 | MN | MD | Speech-Language Pathologist |
| 10032-33 | WI | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Infinite Health Collaborative, PA | Current | Accepting new patients | |
| Westfields Hospital, Inc | Current | Accepting new patients | |
| Infinite Health Collaborative, PA | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Westfields Hospital, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Infinite Health Collaborative, PA | Past | Accepting new patients | |
| St. Croix Orthopaedics, PA | Past | Accepting new patients |
Locations
2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600
3500 American Blvd W
Ste 300
Minneapolis, MN 55431
Phone (952) 512-5600
4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155
3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048
3366 Oakdale Ave N
Ste 200
Robbinsdale, MN 55422
Phone (763) 287-5000
5715 Memorial Ave N
Stillwater, MN 55082
Phone (514) 398-8076
921 Greeley St S
Stillwater, MN 55082
265 Griffin St E
Amery, WI 54001
Phone (715) 268-0308
535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013
744 E Louisiana St
St Croix Fls, WI 54024
Phone (651) 772-6251
Organizations & group practices 11
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.
-
- Orthopaedic Surgery Physician
- Bloomington, MN
- NPI 1164474250
-
dba HealthPartners Medical Group
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
WI
-
dba Amery Hospital & Clinic
- Critical Access Hospital
- Amery, WI
- NPI 1093763518
-
dba Westfields Hospital
- Critical Access Hospital
- New Richmond, WI
- NPI 1881640183
-
dba HealthPartners Clinic Stillwater Lakeview Campus
- Family Medicine Physician
- Stillwater, MN
- NPI 1578932943
-
dba HealthPartners Midway Residency Dental
- General Practice Dentistry
- Saint Paul, MN
- NPI 1952042053
-
dba Amery Hospital & Clinic - Luck
- Rural Health Clinic/Center
- Luck, WI
- NPI 1851345268
-
- Durable Medical Equipment & Medical Supplies
- Hudson, WI
- NPI 1568840916
-
- Hematology & Oncology Physician
- Osceola, WI
- NPI 1477228070
-
- Specialist
- Oak Park Heights, MN
- NPI 1255337945
-
- Durable Medical Equipment & Medical Supplies
- River Falls, WI
- NPI 1144608589
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Fairview Woodwinds Hospital
- General Acute Care Hospital
- Woodbury, MN
- NPI 1356309322
-
dba Lakeview Hospital
- General Acute Care Hospital
- Stillwater, MN
- NPI 1538138003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781654400000",
"number": "1245744234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 AMERICAN BLVD W STE 300",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554314442",
"telephone_number": "952-512-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5715 MEMORIAL AVE N",
"city": "OAK PARK HEIGHTS",
"state": "MN",
"postal_code": "550821093",
"telephone_number": "651-439-8807",
"fax_number": "651-439-0232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKELSON",
"first_name": "AMANDA",
"middle_name": "J",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-29",
"last_updated": "2026-06-17",
"certification_date": "2026-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MN",
"license": "5658",
"primary": true
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WI",
"license": "10032-33",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oak Park Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.