NPIMap

Individual provider Active NPI

Courtney Lynn Plemel, MD

  • Pediatrics Physician
  • Rogers, MN
National Provider Identifier
1316508161
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
73844 Issued in MN
Practice address
13688 Rogers Dr Ste 230
Rogers, MN 55374-4918
Phone
(952) 977-0300
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8563 NE
Pediatrics Physician 208000000X 8563 NE
Pediatrics Physician 208000000X 73844 MN Primary

Addresses

Primary practice location

13688 Rogers Dr Ste 230
Rogers, MN 55374-4918

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

986270 Nebraska Medical Ctr
Omaha, NE 68198-6270
Phone (402) 559-7792

Other names 1

  • Courtney Lynn Tusler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230915001019 MN Practitioner - Pediatric Medicine 3577895499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Minnesota Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

15800 95TH Ave N
Maple Grove, MN 55369-4400
Phone (952) 993-1440

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Pediatrics CurrentSince Sep 11, 2023 Accepting new patients
Park Nicollet Clinic Pediatrics CurrentSince Sep 11, 2023 Accepting new patients
Park Nicollet Clinic Pediatrics Current Accepting new patients
Maple Grove Hospital Corporation Past Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

13688 Rogers Dr
Ste 230
Rogers, MN 55374
Phone (952) 949-1035

13688 Rogers Dr
Rogers, MN 55374
Phone (952) 977-0300

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 7

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": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1316508161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13688 ROGERS DR STE 230",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744918",
            "telephone_number": "952-977-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "986270 Nebraska Medical Ctr",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681986270",
            "country_code": "US",
            "telephone_number": "402-559-7792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLEMEL",
        "first_name": "COURTNEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "8563",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "8563",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "73844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "TUSLER",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rogers, MN

Sources for this page

Verify at the official NPI Registry.