Individual provider Active NPI

Lesa Jo Thielke, APRN, FNP-C

  • Family Nurse Practitioner
  • Appleton, MN
National Provider Identifier
1255041703
Registry record updated Nov 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9759 Issued in MN
Practice address
30 S Behl St
Appleton, MN 56208-1616
Phone
(320) 289-1580
NPI assigned
Nov 24, 2022
Last updated
Nov 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2022

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 9759 MN Primary

Addresses

Primary practice location

30 S Behl St
Appleton, MN 56208-1616

Mailing address

30 S Behl St
Appleton, MN 56208-1616
Phone (320) 289-1580

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
I20230310001799 MN Practitioner - Nurse Practitioner 5698148765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appleton Area HealthGroup PAC ID 7618952565, shared by 4 NPIs, 18 clinicians

Practice addresses (Care Compare)

30 S Behl St
Appleton, MN 56208-1616
Phone (320) 289-2422

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Appleton Area Health CurrentSince Nov 1, 2022 Accepting new patients
Appleton Area Health CurrentSince Nov 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lthielke672416@direct.centracare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1669248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669248000000",
    "number": "1255041703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S BEHL ST",
            "city": "APPLETON",
            "state": "MN",
            "postal_code": "562081616",
            "telephone_number": "320-289-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S BEHL ST",
            "city": "APPLETON",
            "state": "MN",
            "postal_code": "562081616",
            "telephone_number": "320-289-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELKE",
        "first_name": "LESA",
        "middle_name": "JO",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-24",
        "last_updated": "2022-11-24",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "9759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, MN

Sources for this page

Verify at the official NPI Registry.