Individual provider Active NPI

Lisa Braatz, CNP

  • Family Nurse Practitioner
  • Bloomington, MN
National Provider Identifier
1548922883
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8653 Issued in MN
Practice address
8936 Lyndale Ave S
Bloomington, MN 55420-2742
Phone
(952) 881-0163
NPI assigned
Oct 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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 8653 MN Primary

Addresses

Primary practice location

8936 Lyndale Ave S
Bloomington, MN 55420-2742

Mailing address

8936 Lyndale Ave S
Bloomington, MN 55420-2742

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
I20211202001497 MN Practitioner - Nurse Practitioner 9335539550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Richfield Medical Group LTDGroup PAC ID 9032154497, 7 clinicians

Practice addresses (Care Compare)

44 W 66TH St
Richfield, MN 55423-2316

8170 Old Carriage CT
Suite 100
Shakopee, MN 55379-3164
Phone (952) 428-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8653MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Richfield Medical Group LTD CurrentSince Nov 6, 2023 Accepting new patients
St. Francis Regional Medical Center CurrentSince Oct 13, 2021 Accepting new patients
Fairview Pharmacy Services LLC Past Accepting new patients

Locations

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

44 W 66th St
Unit 10
Richfield, MN 55423
Phone (612) 861-1622

6150 Egan Dr
Savage, MN 55378
Phone (952) 228-2552

8170 Old Carriage Ct
Ste 100
Shakopee, MN 55379
Phone (952) 428-3600

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: lbraatz650276@fairview.direct-ci.com

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

Hospital & facility affiliations 5

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": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1548922883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8936 LYNDALE AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554202742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8936 LYNDALE AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554202742",
            "telephone_number": "952-881-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAATZ",
        "first_name": "LISA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.