Individual provider Active NPI

Susan J McIntyre, N.P.

  • Nurse Practitioner
  • New Richmond, WI
National Provider Identifier
1528037447
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3315 Issued in MN
Practice address
535 Hospital Rd
New Richmond, WI 54017-1449
Phone
(715) 243-2600
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3315 MN Primary

Addresses

Primary practice location

535 Hospital Rd
New Richmond, WI 54017-1449

Mailing address

8170 33Rd Ave S
Ms: 21110Q
Bloomington, MN 55425

Other practice location 1

921 Greeley St S
Stillwater, MN 55082-5935
Phone (651) 439-1234

Other practice location 2

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040
Phone (651) 439-1234

Other practice location 3

411 Stageline Rd Ste 200
Hudson, WI 54016-7848
Phone (715) 531-6700

Other identifiers 8

IdentifierTypeStateIssuer
16A22MCOtherMNBLUE CROSS BLUE SHIELD MN
239823100MedicaidMN
1010196OtherMNPREFERREDONE
1552595OtherMNAMERICA'S PPO
43940000MedicaidWI
0401004OtherMNMEDICA
HP32938OtherMNHEALTHPARTNERS
151526OtherMNUCARE MN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Oncology Hematology, PA Nurse Practitioner Past Accepting new patients
Minnesota Oncology Hematology, PA Adult Health Past Accepting new patients
Minnesota Oncology Hematology, PA PastSince Jan 12, 2020 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1528037447",
    "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": "55425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 HOSPITAL RD",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540171449",
            "telephone_number": "715-243-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 Greeley St S",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "MN",
            "postal_code": "550825935",
            "country_code": "US",
            "telephone_number": "651-439-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Curve Crest Blvd W",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "MN",
            "postal_code": "550826040",
            "country_code": "US",
            "telephone_number": "651-439-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 Stageline Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540167848",
            "country_code": "US",
            "telephone_number": "715-531-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "3315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "16A22MC",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "239823100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "1010196",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "1552595",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43940000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0401004",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP32938",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MN",
            "identifier": "151526",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Richmond, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.