NPIMap

Individual provider Active NPI

Emily Marie Reisdorf, DNP, APRN,CNP, FNP-C

  • Family Nurse Practitioner
  • Shakopee, MN
National Provider Identifier
1326883182
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11708 Issued in MN
Practice address
4201 Dean Lakes Blvd Ste 120
Shakopee, MN 55379-2850
Phone
(952) 496-6700
Fax
(952) 445-6448
NPI assigned
Jun 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11708 MN Primary

Addresses

Primary practice location

4201 Dean Lakes Blvd Ste 120
Shakopee, MN 55379-2850

Mailing address

4201 Dean Lakes Blvd Ste 120
Shakopee, MN 55379-2850
Phone (952) 496-6700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ereisdorf324909@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241003001232 MN Practitioner - Nurse Practitioner 1557892395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
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)

4201 Dean Lakes Blvd
Suite 120
Shakopee, MN 55379-2850
Phone (952) 496-6700

Hospital & facility affiliations

  • St Francis Regional Medical Center Hospital, Shakopee, MN, CCN 240104
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Sep 3, 2024 Accepting new patients
Allina Health System CurrentSince Sep 3, 2024 Accepting new patients
St. Francis Regional Medical Center CurrentSince Sep 3, 2024 Accepting new patients
St Francis Regional Medical Center CurrentSince Sep 3, 2024 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

4201 Dean Lakes Blvd
Ste 120
Shakopee, MN 55379
Phone (952) 496-6700

Interoperability endpoints

  • Direct secure messaging: ereisdorf324909@excellian.direct.allina.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 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1326883182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 DEAN LAKES BLVD STE 120",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792850",
            "telephone_number": "952-496-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 DEAN LAKES BLVD STE 120",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792850",
            "telephone_number": "952-496-6700",
            "fax_number": "952-445-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISDORF",
        "first_name": "EMILY",
        "middle_name": "MARIE",
        "credential": "DNP, APRN,CNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "11708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ereisdorf324909@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "4201 Dean Lakes Blvd Ste 120",
            "city": "Shakopee",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553792850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.