Individual provider Active NPI

Matthew L McGraw, APRN

  • Adult Health Nurse Practitioner
  • Fridley, MN
National Provider Identifier
1265797930
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
6159 Issued in MN
Practice address
550 Osborne Rd NE
Fridley, MN 55432-2718
Phone
(651) 635-9173
Fax
(651) 628-2999
NPI assigned
Jul 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 6159 MN Primary

Addresses

Primary practice location

550 Osborne Rd NE
Fridley, MN 55432-2718

Mailing address

PO Box 43
Minneapolis, MN 55440-0043
Phone (612) 262-1166

Other practice location 1

5320 W 23rd St Ste 130
St Louis Park, MN 55416-1670
Phone (952) 345-8770

Other identifiers 2

IdentifierTypeStateIssuer
6159OtherMNCERTIFIED NURSE PRACTITIONER
APN.0991439-NPOtherCOSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmcgraw409599@excellian.direct.allina.com Direct

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
I20181129001563 MN Practitioner - Nurse Practitioner 5496907289 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

550 Osborne Rd NE
Fridley, MN 55432-2718
Phone (763) 427-9980

Hospital & facility affiliations

  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

Merit-based Incentive Payment System (MIPS)

Final score
87.25 of 100Reported as group
Quality
60.43
Promoting interoperability
83
Improvement activities
40
Cost
79.28

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6159MNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jul 1, 2024 Accepting new patients
Lifespark Medical Group, PA Adult Health CurrentSince Aug 28, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Past Accepting new patients

Locations

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

550 Osborne Rd NE
Minneapolis, MN 55432
Phone (763) 236-3800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

5320 W 23rd St
Ste 130
St Louis Park, MN 55416
Phone (952) 345-3213

Interoperability endpoints

  • Direct secure messaging: mmcgraw409599@excellian.direct.allina.com

Organizations & group practices 4

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 8

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": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1265797930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 OSBORNE RD NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322718",
            "telephone_number": "651-635-9173",
            "fax_number": "651-628-2999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5320 W 23rd St Ste 130",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554161670",
            "country_code": "US",
            "telephone_number": "952-345-8770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGRAW",
        "first_name": "MATTHEW",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "6159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSE PRACTITIONER",
            "identifier": "6159",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APN.0991439-NP",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmcgraw409599@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "550 Osborne Rd NE",
            "city": "Fridley",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554322718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.