Active NPI
Renee Sara Leisen Fisher, FNP-C
- Nurse Practitioner
- Champlin, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 9595
- Practice address
- 12142 Business Park Blvd N
Champlin, MN 55316-4525 - Phone
- (952) 977-0500
- NPI assigned
- Jul 6, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9595 | MN | |
| Registered Nurse | 163W00000X | 2015284 | MN | |
| Nurse Practitioner | 363L00000X | 9595 | MN | Primary |
Addresses
Primary practice location
12142 Business Park Blvd N
Champlin, MN 55316-4525
Mailing address
8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516
Other names 1
- Renee Leisen
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12142 Business Park Blvd N
Champlin, MN 55316-4525
Phone (952) 977-0500
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9595 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients |
Locations
12142 Business Park Blvd N
Champlin, MN 55316
Phone (952) 977-0500
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
Interoperability endpoints
- rleisen151929@direct.healthpartners.com
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.
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1063897593
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maple Grove, MN
- NPI 1174980692
-
dba Park Nicollet Methodist Hospital Outpatient Surgery Center
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1194113217
-
dba PN Methodist Hospital Episodic Bundle
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1245615772
-
dba Park Nicollet Melrose Center
- Mental Illness Community Based Residential Treatment Facility
- St Louis Park, MN
- NPI 1578717336
Hospital
-
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1649220724
-
dba Park Nicollet Melrose Center
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1942585286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764892800000",
"number": "1336872498",
"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": "12142 BUSINESS PARK BLVD N",
"city": "CHAMPLIN",
"state": "MN",
"postal_code": "553164525",
"telephone_number": "952-977-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEISEN FISHER",
"first_name": "RENEE",
"middle_name": "SARA",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-06",
"last_updated": "2025-12-05",
"certification_date": "2025-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "9595",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "2015284",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "9595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RENEE",
"last_name": "LEISEN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Champlin, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; 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.