Individual provider Active NPI

Deanna Ebert, C.N.P.

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1538693247
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP 5071 Issued in MN
Practice address
401 Harding St NE Ste 100
Minneapolis, MN 55413-2801
Phone
(651) 571-0000
NPI assigned
Apr 19, 2017
Last updated
Nov 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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 CNP 5071 MN Primary

Addresses

Primary practice location

401 Harding St NE Ste 100
Minneapolis, MN 55413-2801

Mailing address

401 Harding St NE Ste 100
Minneapolis, MN 55413-2801
Phone (651) 571-0000

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
I20170906001012 MN Practitioner - Nurse Practitioner 5799058236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yourpath Care, PLLCGroup PAC ID 4486017050, 3 clinicians

Practice addresses (Care Compare)

700 Raymond Ave
Suite 130
Saint Paul, MN 55114-1778
Phone (612) 895-1510

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP 5071MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yourpath Care, PLLC CurrentSince Aug 1, 2023 Accepting new patients
Daniel B Grossman M D Inc PastSince Jun 21, 2022 Accepting new patients

Locations

700 Raymond Ave
Ste 130
Saint Paul, MN 55114
Phone (612) 895-1510

Interoperability endpoints

  • Direct secure messaging: deanna.ebert.1@22578.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1538693247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HARDING ST NE STE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132801",
            "telephone_number": "651-571-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HARDING ST NE STE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132801",
            "telephone_number": "651-571-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERT",
        "first_name": "DEANNA",
        "name_prefix": "Ms.",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 5071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.