Individual provider Active NPI

Prudence Mpofu, FNP

  • Family Nurse Practitioner
  • Hibbing, MN
National Provider Identifier
1487112652
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A140430 Issued in IA
Practice address
750 E 34TH St
Hibbing, MN 55746-2341
Phone
(218) 262-4881
NPI assigned
Mar 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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 A140430 IA Primary

Addresses

Primary practice location

750 E 34TH St
Hibbing, MN 55746-2341

Mailing address

1040 Patrick CT Apt 107
Waterloo, IA 50701-4405

Other practice location 1

1040 Patrick Ct
Waterloo, IA 50701-4472
Phone (515) 326-2642

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
I20190619002236 MN Practitioner - Nurse Practitioner 6709110182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Range Regional Health ServicesGroup PAC ID 8022920024, 349 clinicians

Practice addresses (Care Compare)

750 E 34TH St
Hibbing, MN 55746-4600
Phone (218) 262-4881

Hospital & facility affiliations

  • Range Regional Health Services Hospital, Hibbing, MN, CCN 240040

Merit-based Incentive Payment System (MIPS)

Final score
96.93 of 100Reported as group
Quality
94.88
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6582MNMDClinical Psychologist
A140430IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Range Regional Health Services CurrentSince Jun 17, 2019 Accepting new patients
Range Regional Health Services CurrentSince Jun 17, 2019 Accepting new patients
Range Regional Health Services Current Accepting new patients

Locations

1814 14th Ave E
Hibbing, MN 55746
Phone (218) 262-3441

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

Organizations & group practices 3

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 1

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": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1487112652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 PATRICK CT APT 107",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E 34TH ST",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462341",
            "telephone_number": "218-262-4881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1040 Patrick Ct",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IA",
            "postal_code": "507014472",
            "country_code": "US",
            "telephone_number": "515-326-2642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MPOFU",
        "first_name": "PRUDENCE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A140430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hibbing, MN

Sources for this page

Verify at the official NPI Registry.