Individual provider Active NPI

Bethany Anne Hjelle, CNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Maple Grove, MN
National Provider Identifier
1255806428
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
6225 Issued in MN
Practice address
9825 Hospital Dr Ste 205
Maple Grove, MN 55369-4480
Phone
(763) 587-7000
Fax
(763) 587-7015
NPI assigned
Oct 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 6225 MN Primary

Addresses

Primary practice location

9825 Hospital Dr Ste 205
Maple Grove, MN 55369-4480

Mailing address

9825 Hospital Dr Ste 205
Maple Grove, MN 55369-4480
Phone (763) 587-7000

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
I20181105000151 MN Practitioner - Nurse Practitioner 5799038097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier OBGYN of Minnesota PLLCGroup PAC ID 1355396110, 88 clinicians

Practice addresses (Care Compare)

9825 Hospital Dr
Suite 205
Maple Grove, MN 55369-4480
Phone (763) 587-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.24 of 100Reported as group
Quality
86.35
Promoting interoperability
100
Improvement activities
40
Cost
71.1

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6225MNMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier OBGYN of Minnesota PLLC CurrentSince Oct 1, 2018 Accepting new patients
Metropolitan Obstetrics & Gynecology Past Accepting new patients

Locations

11855 Ulysses St NE
Ste 240
Blaine, MN 55434

9825 Hospital Dr
Ste 205
Maple Grove, MN 55369
Phone (763) 587-7000

3007 Harbor Ln N
Ste 1400
Plymouth, MN 55447
Phone (763) 587-7000

Interoperability endpoints

  • Direct secure messaging: bethany.hjelle.1@20897.direct.athenahealth.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 and National Provider Directory roles.

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": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1255806428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR STE 205",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694480",
            "telephone_number": "763-587-7000",
            "fax_number": "763-587-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR STE 205",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694480",
            "telephone_number": "763-587-7000",
            "fax_number": "763-587-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HJELLE",
        "first_name": "BETHANY",
        "middle_name": "ANNE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MN",
            "license": "6225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.