Individual provider Active NPI

Angela Kathleen Smaciarz, NP

  • Adult Health Nurse Practitioner
  • Coon Rapids, MN
National Provider Identifier
1346631280
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CNP 3712 Issued in MN
Practice address
9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone
(763) 780-8155
NPI assigned
Feb 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R 188589-7 MN
Gerontology Nurse Practitioner 363LG0600X CNP 3712 MN
Adult Health Nurse Practitioner 363LA2200X CNP 3712 MN Primary

Addresses

Primary practice location

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841

Mailing address

2925 Chicago Avenue
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other practice location 1

3800 Coon Rapids Blvd NW Ste 3800
Coon Rapids, MN 55433-2517
Phone (763) 452-3955

Other names 1

  • Angela Kathleen Pry Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address asmaciarz216274@excellian.direct.allina.com Direct
Direct Messaging Address angela.smaciarz.nss@direct.mlcmsi.nextgenshare.com

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
I20151007003246 MN Practitioner - Nurse Practitioner 2365750528 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

  • Buffalo Hospital Hospital, Buffalo, MN, CCN 240076
  • Cambridge Medical Center Hospital, Cambridge, MN, CCN 240020
  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 188589-7MNMDRegistered Nurse
CNP 3712MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Sep 5, 2015 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Sep 5, 2015 Accepting new patients
Allina Health System Current Accepting new patients
Northstar Sleep Center LLC CurrentSince Sep 5, 2015 Accepting new patients
Allina Health System Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

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

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

1540 Lake St S
Forest Lake, MN 55025
Phone (651) 464-7100

4570 77th St W
Ste 150
Minneapolis, MN 55435

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

3800 Coon Rapids Blvd NW
#380
Minneapolis, MN 55433

3800 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 452-3955

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

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

Interoperability endpoints

  • Direct secure messaging: asmaciarz216274@excellian.direct.allina.com
  • Direct secure messaging: angela.smaciarz.p1@direct.mlcmsi.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1346631280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVENUE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9055 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335841",
            "telephone_number": "763-780-8155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Coon Rapids Blvd NW Ste 3800",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332517",
            "country_code": "US",
            "telephone_number": "763-452-3955",
            "fax_number": "763-452-3956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMACIARZ",
        "first_name": "ANGELA",
        "middle_name": "KATHLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-13",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R 188589-7",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "CNP 3712",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "CNP 3712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asmaciarz216274@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "9055 Springbrook Dr NW",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554335841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angela.smaciarz.nss@direct.mlcmsi.nextgenshare.com",
            "affiliation": "N",
            "address_1": "3800 Coon Rapids Blvd NW Ste 3800",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554332517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "PRY",
            "middle_name": "KATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.