Active NPI
Lori Ann Nidever Nidersson, M.D.
- Anesthesiology Physician
- Robbinsdale, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 47739
- Practice address
- 3300 Oakdale Ave N
Robbinsdale, MN 55422-2926 - Phone
- (763) 581-3982
- NPI assigned
- Aug 16, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 47739 | MN | Primary |
Addresses
Primary practice location
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Mailing address
14700 28TH Ave N
Suite 20
Plymouth, MN 55447-4835
Phone (763) 559-3779
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Minnesota Medical School, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3300 N Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-5370
9855 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 898-1000
9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 898-1000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Memorial Health Care | Current | Accepting new patients | |
| Anesthesiology, P.a. | Anesthesiology | Current | Accepting new patients |
| North Memorial Health Care | Current | Accepting new patients | |
| North Memorial Health Care | Current | Accepting new patients |
Locations
9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000
2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000
14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779
3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048
Organizations & group practices 4
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.
-
- Anesthesiology Physician
- Robbinsdale, MN
- NPI 1013960798
-
dba North Memorial Health Hospital
- General Acute Care Hospital
- Robbinsdale, MN
- NPI 1851344907
-
dba North Memorial Health Professional Services
- General Acute Care Hospital
- Robbinsdale, MN
- NPI 1568893220
-
- Clinic/Center
- Blaine, MN
- NPI 1841995552
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maple Grove, MN
- NPI 1225272552
-
dba North Memorial Ambulance Service
- Ambulance
- Brooklyn Center, MN
- NPI 1538195912
Hospital
-
dba North Memorial Health Specialty Center - Robbinsdale
- Medical Specialty Clinic/Center
- Robbinsdale, MN
- NPI 1699953000
Hospital
-
dba North Memorial Health Hospital
- General Acute Care Hospital
- Robbinsdale, MN
- NPI 1851344907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475539200000",
"number": "1396937959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14700 28TH AVE N",
"address_2": "SUITE 20",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554474835",
"telephone_number": "763-559-3779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 OAKDALE AVE N",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554222926",
"telephone_number": "763-581-3982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIDERSSON",
"first_name": "LORI",
"middle_name": "ANN NIDEVER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-16",
"last_updated": "2016-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MN",
"license": "47739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Robbinsdale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.