Individual provider Active NPI

Elizabeth Rose, NP

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1336459205
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R161065-1 Issued in MN
Practice address
8900 Highway 7
Minneapolis, MN 55426-3919
Phone
(952) 929-0140
NPI assigned
Oct 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 R161065-1 MN Primary

Addresses

Primary practice location

8900 Highway 7
Minneapolis, MN 55426-3919

Mailing address

4656 Excelsior Blvd
St Louis Park, MN 55416-4938
Phone (952) 929-0140

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110404000109 MN Practitioner - Nurse Practitioner 4688858434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Minnesota PAGroup PAC ID 7810289949, 83 clinicians

Practice addresses (Care Compare)

8900 Hwy 7
Minneapolis, MN 55426-3919
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R161065-1MNMDFamily Nurse Practitioner

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Minnesota, P.a. Family CurrentSince May 13, 2017 Accepting new patients
Minuteclinic Primary Care Minnesota PLLC Family CurrentSince Apr 1, 2025 Accepting new patients

Locations

1010 W Lake St
Minneapolis, MN 55408
Phone (612) 822-1297

1500 109th Ave NE
Minneapolis, MN 55449
Phone (763) 354-1000

8900 Highway 7
St Louis Park, MN 55426
Phone (952) 933-4858

4656 Excelsior Blvd
St Louis Park, MN 55416
Phone (952) 929-0140

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336459205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4656 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164938",
            "telephone_number": "952-929-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 HIGHWAY 7",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554263919",
            "telephone_number": "952-929-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R161065-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.