Individual provider Active NPI

Gertrude Nnebundo Orakwue, CNP

  • Gerontology Nurse Practitioner
  • Woodbury, MN
National Provider Identifier
1316596562
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
6910 Issued in MN
Practice address
4762 Martingale Dr
Woodbury, MN 55129-7544
Phone
(612) 418-0243
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 6910 MN Primary

Addresses

Primary practice location

4762 Martingale Dr
Woodbury, MN 55129-7544

Mailing address

4762 Martingale Dr
Woodbury, MN 55129-7544
Phone (612) 418-0243

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
I20191017001264 MN Practitioner - Nurse Practitioner 7113258476 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (952) 914-1720

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6910MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Mar 15, 2025 Accepting new patients
Fairview Clinics Current Accepting new patients
Matrix Medical Plus CurrentSince May 1, 2024 Accepting new patients
Olmsted Medical Center CurrentSince Oct 21, 2019 Accepting new patients
Olmsted Medical Center CurrentSince Oct 21, 2019 Accepting new patients
Fairview Clinics CurrentSince Mar 15, 2025 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

121 Washington Ave N
Fl 4
Minneapolis, MN 55401
Phone (404) 992-2702

210 9th St SE
Rochester, MN 55904
Phone (507) 529-6616

1650 4th St SE
Rochester, MN 55904
Phone (507) 285-8485

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Interoperability endpoints

  • Direct secure messaging: gorakwue321790@fairview.direct-ci.com

Organizations & group practices 6

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 4

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": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1316596562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4762 MARTINGALE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551297544",
            "telephone_number": "612-418-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4762 MARTINGALE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551297544",
            "telephone_number": "612-418-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORAKWUE",
        "first_name": "GERTRUDE",
        "middle_name": "NNEBUNDO",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "6910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.