Individual provider Active NPI

Vanessa Lange, PA-C

  • Physician Assistant
  • Maple Grove, MN
National Provider Identifier
1407307077
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12248 Issued in MN
Practice address
14500 99TH Ave N Ste 100
Maple Grove, MN 55369-4738
Phone
(763) 898-1000
NPI assigned
Oct 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 12248 MN
Physician Assistant 363A00000X 12248 MN Primary

Addresses

Primary practice location

14500 99TH Ave N Ste 100
Maple Grove, MN 55369-4738

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727

Other practice location 1

500 Harvard St SE Ste 7445
Minneapolis, MN 55455-0363
Phone (612) 273-0883

Other identifiers 1

IdentifierTypeStateIssuer
1407307077MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vrosen10@umphysicians.umn.edu

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
I20161130002702 MN Practitioner - Physician Assistant 1153601570 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

14500 99TH Ave N
Maple Grove, MN 55369-4730
Phone (763) 898-1000

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

1655 Beam Ave
Suite 111
Maplewood, MN 55109-1475
Phone (651) 471-2233

1700 University Ave W
Saint Paul, MN 55104-3727

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

6525 France Ave S
Suite 200
Edina, MN 55435-2176
Phone (952) 848-8890

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12248MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Physicians CurrentSince Aug 19, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Aug 19, 2019 Accepting new patients
Fairview Express Care CurrentSince Aug 19, 2019 Accepting new patients
Fairview Express Care CurrentSince Aug 19, 2019 Accepting new patients
Fairview Health Services CurrentSince Jul 12, 2019 Accepting new patients
Fairview Health Services CurrentSince Jul 12, 2019 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Jun 12, 2023 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Aug 19, 2019 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients
Fairview Pharmacy Services LLC PastSince Jun 16, 2026 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

7450 France Ave S
Ste 210
Edina, MN 55435
Phone (763) 420-1010

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

14500 99th Ave N
Maple Grove, MN 55369
Phone (763) 898-1000

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

6525 France Ave S
Ste 200
Minneapolis, MN 55435
Phone (952) 848-8890

6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980

500 Harvard St SE
Ste 7445
Minneapolis, MN 55455
Phone (612) 273-0883

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

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

17 Exchange St W
Ste 835
Saint Paul, MN 55102
Phone (651) 232-4200

Interoperability endpoints

  • Direct secure messaging: vanessa.rosen.nss@direct.mlcmsi.nextgenshare.com
  • Direct secure messaging: vanessa.rosen.p1@direct.mlcmsi.nextgenshare.com
  • Direct secure messaging: vlange486529@fairview.direct-ci.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1407307077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 99TH AVE N STE 100",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694738",
            "telephone_number": "763-898-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Harvard St SE Ste 7445",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550363",
            "country_code": "US",
            "telephone_number": "612-273-0883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANGE",
        "first_name": "VANESSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MN",
            "license": "12248",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407307077",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vrosen10@umphysicians.umn.edu",
            "affiliation": "N",
            "address_1": "500 Harvard St SE Ste 7445",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554550363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.