Individual provider Active NPI

Richard T Grode, NP

  • Nurse Practitioner
  • Oakdale, MN
National Provider Identifier
1609837822
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1060049 Issued in MN
Practice address
5405 Helena Rd N
Oakdale, MN 55128-3051
Phone
(651) 353-6273
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 1060049 MN Primary

Addresses

Primary practice location

5405 Helena Rd N
Oakdale, MN 55128-3051

Mailing address

5405 Helena Rd N
Oakdale, MN 55128-3051
Phone (651) 353-6273

Other identifiers 1

IdentifierTypeStateIssuer
749465300MedicaidMN

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
I20050113000955 MN Practitioner - Nurse Practitioner 4981653250

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Key CorporationGroup PAC ID 9032009238, 53 clinicians

Practice addresses (Care Compare)

1394 Jackson St
Saint Paul, MN 55117-4630
Phone (612) 315-5866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1060049MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nura PLLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1609837822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 HELENA RD N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551283051",
            "telephone_number": "651-353-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 HELENA RD N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551283051",
            "telephone_number": "651-353-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODE",
        "first_name": "RICHARD",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "1060049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "749465300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, MN

Sources for this page

Verify at the official NPI Registry.