Individual provider Active NPI

Sarah Shueb

  • Dentist
  • Minneapolis, MN
National Provider Identifier
1275185092
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
FL58 Issued in MN
Practice address
515 Delaware St SE
Minneapolis, MN 55455-0357
Phone
(612) 626-0140
NPI assigned
Jul 11, 2019
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X FL58 MN Primary

Addresses

Primary practice location

515 Delaware St SE
Minneapolis, MN 55455-0357

Mailing address

515 Delaware St SE
Minneapolis, MN 55455-0357

Other practice location 1

515 Delaware St SE
Minneapolis, MN 55455-0357
Phone (612) 626-0140

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200727002691 MN Practitioner - DentistPractitioner - Pain Management 7810311602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DentistAlso: Pain Management
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3475 Plymouth Blvd
Suite 200
Plymouth, MN 55447-1539
Phone (763) 577-2484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FL58MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Head and Neck Pain Clinic, PA CurrentSince Aug 1, 2020 Accepting new patients
Minnesota Head and Neck Pain Clinic, PA CurrentSince Aug 1, 2020 Accepting new patients

Locations

675 E Nicollet Blvd
Ste 255
Burnsville, MN 55337
Phone (952) 892-6222

3475 Plymouth Blvd
Ste 200
Plymouth, MN 55447
Phone (763) 577-2484

2550 University Ave W
Ste 189S
Saint Paul, MN 55114
Phone (651) 332-7470

Interoperability endpoints

  • Direct secure messaging: sarah.shueb.1@13597.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1275185092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-626-0140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Delaware St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550357",
            "country_code": "US",
            "telephone_number": "612-626-0140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUEB",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "FL58",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.