NPIMap

Individual provider Active NPI

Rachelle Jean Pucelj, APRN, CNP

  • Family Nurse Practitioner
  • Virginia, MN
National Provider Identifier
1407562770
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10028 Issued in MN
Practice address
901 9TH St N
Virginia, MN 55792-2325
Phone
(218) 741-3340
NPI assigned
Jan 30, 2023
Last updated
Mar 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10028 MN Primary

Addresses

Primary practice location

901 9TH St N
Virginia, MN 55792-2325

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230405003002 MN Practitioner - Nurse Practitioner 6406221365 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

1101 9TH St N
Virginia, MN 55792-2329
Phone (218) 741-0150

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

603 9TH St N
Virginia, MN 55792-2319
Phone (218) 741-3013

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10028MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Medical Center CurrentSince Apr 24, 2023 Accepting new patients
Essentia Health Moose Lake CurrentSince Apr 24, 2023 Accepting new patients
Pine Medical Center CurrentSince Apr 24, 2023 Accepting new patients
The Duluth Clinic, LTD CurrentSince Apr 24, 2023 Accepting new patients
Essentia Health Moose Lake Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Apr 24, 2023 Accepting new patients
Matrix Medical Plus CurrentSince May 1, 2025 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
Essentia Health Virginia, LLC Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

2501 Keenan Dr
Intl Falls, MN 56649
Phone (218) 283-4481

121 Washington Ave N
Fl 4
Minneapolis, MN 55401
Phone (404) 992-2702

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

705 Lundorff Dr
Sandstone, MN 55072
Phone (320) 245-2211

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

Organizations & group practices 12

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.

Hospital & facility affiliations 7

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": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1407562770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 9TH ST N",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922325",
            "telephone_number": "218-741-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCELJ",
        "first_name": "RACHELLE",
        "middle_name": "JEAN",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "10028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia, MN

Sources for this page

Verify at the official NPI Registry.