Individual provider Active NPI

Rebecca Rathjen

  • Social Worker
  • Brooklyn Park, MN
National Provider Identifier
1356749907
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
21760 Issued in MN
Practice address
10000 Zane Ave N
Brooklyn Park, MN 55443-1400
Phone
(612) 672-6999
NPI assigned
Dec 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 21760 MN Primary

Addresses

Primary practice location

10000 Zane Ave N
Brooklyn Park, MN 55443-1400

Mailing address

704 Princeton St Apt 2
Ann Arbor, MI 48103-4886

Other practice location 1

704 Princeton St Apt 2
Ann Arbor, MI 48103-4886
Phone (952) 297-5632

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180827000548 MN Practitioner - Clinical Social Worker 4183973043 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centered PracticeGroup PAC ID 8527232198, 7 clinicians

Practice addresses (Care Compare)

401 Division St S
Suite C
Northfield, MN 55057-2096
Phone 50764972941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Dec 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2020 Accepting new patients
Centered Practice CurrentSince Nov 1, 2022 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Jul 13, 2018 Accepting new patients

Locations

10000 Zane Ave N
Minneapolis, MN 55443
Phone (763) 528-6999

2450 Riverside Ave
Ste F140
Minneapolis, MN 55454
Phone (651) 464-4847

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

401 Division St S
Ste C
Northfield, MN 55057
Phone (507) 645-0444

1619 Dayton Ave
Ste 303
Saint Paul, MN 55104
Phone (651) 605-6020

Organizations & group practices 7

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": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1356749907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 PRINCETON ST APT 2",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431400",
            "telephone_number": "612-672-6999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 Princeton St Apt 2",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481034886",
            "country_code": "US",
            "telephone_number": "952-297-5632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RATHJEN",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-15",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "21760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

Verify at the official NPI Registry.