Individual provider Active NPI

Shaena Kuch, FNP-BC

  • Nurse Practitioner
  • Grand Forks, ND
National Provider Identifier
1609605435
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
200347 Issued in ND
Practice address
Altru Professional Center
4440 S. Washington St.
Grand Forks, ND 58201
Phone
(218) 368-0728
NPI assigned
Jul 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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 200347 ND Primary

Addresses

Primary practice location

Altru Professional Center
4440 S. Washington St.
Grand Forks, ND 58201

Mailing address

PO Box 13780
Grand Forks, ND 58208
Phone (701) 780-1891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250411002419 ND Practitioner - Nurse Practitioner 6305370784 Reassigns benefits to 2 organizations
I20250715002967 MN Practitioner - Nurse Practitioner 6305370784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health SystemGroup PAC ID 1355251604, shared by 14 NPIs, 675 clinicians

Practice addresses (Care Compare)

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

4440 S Washington St
Grand Forks, ND 58201-7245
Phone (701) 780-5000

607 Demers Ave
East Grand Forks, MN 56721-1833
Phone (218) 773-0357

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medallus & Vacharothone LTD Nurse Practitioner CurrentSince Jan 23, 2025 Accepting new patients
Altru Health System CurrentSince May 18, 2025 Accepting new patients
Altru Health System CurrentSince May 18, 2025 Accepting new patients
Altru Health System Current Accepting new patients
Altru Health System CurrentSince May 18, 2025 Accepting new patients
Altru Health System Past Accepting new patients

Locations

607 Demers Ave
East Grand Forks, MN 56721
Phone (218) 773-0357

2701 Uptown Way S
Fargo, ND 58104
Phone (701) 368-4380

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

725 Hamline St
Grand Forks, ND 58203
Phone (701) 777-6800

4440 S Washington St
Grand Forks, ND 58201
Phone (701) 732-7000

721 1st Ave S
Ste A
Jamestown, ND 58401
Phone (701) 368-4380

Organizations & group practices 6

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": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1609605435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13780",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58208",
            "telephone_number": "701-780-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ALTRU PROFESSIONAL CENTER",
            "address_2": "4440 S. WASHINGTON ST.",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "218-368-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCH",
        "first_name": "SHAENA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2025-06-16",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "200347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.