Individual provider Active NPI

Cathleen Renee Clouse, MD

  • Family Medicine Physician
  • Apple Valley, MN
National Provider Identifier
1346204120
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43288 Issued in MN
Practice address
15290 Pennock LN
Apple Valley, MN 55124-7163
Phone
(952) 853-8800
Fax
(952) 431-6966
NPI assigned
Apr 17, 2006
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43288 MN Primary

Addresses

Primary practice location

15290 Pennock LN
Apple Valley, MN 55124-7163

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
165186200MedicaidMN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050420001198 MN Practitioner - Family Practice 3577501410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

205 Wabasha Ave S
Saint Paul, MN 55107-1805
Phone (651) 293-8100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43288MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Family Medicine CurrentSince Aug 28, 2017 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Aug 28, 2017 Accepting new patients
Urgent Care Doctors Office, PA Family Medicine Past Accepting new patients
North Memorial Health Care Past Accepting new patients

Locations

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

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

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

15290 Pennock Ln
Saint Paul, MN 55124
Phone (952) 431-8500

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1346204120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15290 PENNOCK LN",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247163",
            "telephone_number": "952-853-8800",
            "fax_number": "952-431-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUSE",
        "first_name": "CATHLEEN",
        "middle_name": "RENEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "43288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165186200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.