Individual provider Active NPI

Nathaniel Vanloon, PA-C

  • Physician Assistant
  • Apple Valley, MN
National Provider Identifier
1437781333
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13182 Issued in MN
Practice address
14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone
(952) 432-6161
NPI assigned
Feb 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13182 MN Primary

Addresses

Primary practice location

14655 Galaxie Ave
Apple Valley, MN 55124-8602

Mailing address

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

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
I20200312000545 MN Practitioner - Physician Assistant 9537597273 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Odom Sports Medicine PAGroup PAC ID 0143485607, 63 clinicians
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

10653 Wayzata Blvd
Minnetonka, MN 55305-1543
Phone (952) 224-1919

14655 Galaxie Ave
Apple Valley, MN 55124-8602

18465 Orchard TRL
Lakeville, MN 55044-8885
Phone (952) 428-0950

2925 Chicago Ave
Minneapolis, MN 55407-1321

3270 W Lake St
Minneapolis, MN 55416-4512
Phone (612) 775-1800

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

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13182MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Mar 23, 2020 Accepting new patients
Allina Health System CurrentSince Mar 23, 2020 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System Past Accepting new patients

Locations

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

9409 Zane Ave N
Brooklyn Park, MN 55443
Phone (763) 488-4502

2833 Chicago Ave
Ste 406
Minneapolis, MN 55407

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

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

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

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

5565 Blaine Ave
South St Paul, MN 55076
Phone (651) 241-9400

150 Emerson Ave E
West St Paul, MN 55118
Phone (651) 241-1800

1400 N Acres Rd
Prescott, WI 54021
Phone (715) 262-4441

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": "1581120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1437781333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "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": "14655 GALAXIE AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248602",
            "telephone_number": "952-432-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLOON",
        "first_name": "NATHANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-08",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.