Mary Irene Wangechi

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

6895 Issued in MN

Practice address

1415 Lilac Dr N Ste 190
Golden Valley, MN 55422-4544

Phone

(763) 267-8701

NPI assigned

Jan 6, 2021

Last updated

Jan 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Curana Health of Minnesota PLLCGroup PAC ID 6305233461, 62 clinicians

Lifespark Medical Group PAGroup PAC ID 4385908201, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.wangechi.2@17901.direct.athenahealth.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Curana Health of Minnesota PLLC

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1083365084
  Medicare reassignment Care Compare group NPD
• Lifespark Medical Group, PA

  dba Lifesprk Health

  • Geriatric Medicine (Family Medicine) Physician
  • St Louis Park, MN
  • NPI 1427551746

  Gerontology

  Medicare reassignment Care Compare group NPD
• CH Specialty Services MN PC

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1841999158
  Medicare reassignment NPD
• Spark Medical Providers PA

  • Geriatric Medicine (Internal Medicine) Physician
  • St Louis Park, MN
  • NPI 1760374680
  Medicare reassignment NPD
• Twin Cities Physicians Professional Corporation

  • Multi-Specialty Clinic/Center
  • Golden Valley, MN
  • NPI 1992176499
  Medicare reassignment NPD

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1295323277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGECHI",
        "first_name": "MARY",
        "middle_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "6895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #00430)
• Wendy Sue Walker, LICSW
• Krystle E Lieberman Wall, DC, RD, LD, CBS LC
• Caylynn Ann Wallace-Marcelle, ARNP, CPNP
• Allison Wallace, LICSW
• Warm Hands Kind Hearts Home Care
• Lisa Marie Wassermann
• Marin Ilene Parsons Watters, DDS
• Bradley Watts, D.C.
• Laura Louise Wearne, DPT

• Gerontology Nurse Practitioner in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.

Verify at the official NPI Registry.