Individual provider Active NPI

Catherine Conzemius Van de Velde

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1487099016
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R161057-0 Issued in MN
Practice address
205 Wabasha St S
Saint Paul, MN 55107-1805
Phone
(651) 293-8100
Fax
(651) 293-8106
NPI assigned
May 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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 R161057-0 MN Primary

Addresses

Primary practice location

205 Wabasha St S
Saint Paul, MN 55107-1805

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516
Phone (651) 293-8100

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
I20130927000659 MN Practitioner - Nurse Practitioner 2264666593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

205 Wabasha Ave S
Saint Paul, MN 55107-1805
Phone (651) 227-3757

Hospital & facility affiliations

  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R161057-0MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Jul 9, 2013 Accepting new patients
Group Health, Inc. CurrentSince Jul 9, 2013 Accepting new patients

Locations

15350 English Ave
Apple Valley, MN 55124
Phone (952) 431-8500

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

8450 Seasons Pkwy
Stop 32900A
Woodbury, MN 55125
Phone (651) 702-5300

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1487099016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-293-8100",
            "fax_number": "651-293-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WABASHA ST S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551071805",
            "telephone_number": "651-293-8100",
            "fax_number": "651-293-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DE VELDE",
        "first_name": "CATHERINE",
        "middle_name": "CONZEMIUS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R161057-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.