Individual provider Active NPI

Michelle A Proska, APRN, CNP

  • Adult Health Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1639325863
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3718 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-3443
NPI assigned
Aug 7, 2008
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R1704554 MN
Adult Health Nurse Practitioner 363LA2200X 3718 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

Essentia Health Duluth Clinic SSB-5
400 E Third Street
Duluth, MN 55805-1951
Phone (218) 786-8364

Other identifiers 2

IdentifierTypeStateIssuer
36091400MedicaidWI
1639325863MedicaidMN

Other names 1

  • Michelle A Miller Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 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
I20081027000739 MN Practitioner - Nurse Practitioner 3678631199 Reassigns benefits to 7 organizations
I20200423001780 WI Practitioner - Nurse Practitioner 3678631199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Wisconsin School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians
Northern Pines Medical CenterGroup PAC ID 3870565641, shared by 4 NPIs, 39 clinicians

Practice addresses (Care Compare)

1101 9TH St N
Virginia, MN 55792-2329
Phone (218) 741-0150

5211 Hwy 110
Aurora, MN 55705-1522
Phone (218) 229-3311

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3718MNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Hospital of Superior Current Accepting new patients
Essentia Health Moose Lake CurrentSince May 11, 2023 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 25, 2008 Accepting new patients
The Duluth Clinic, LTD CurrentSince Aug 25, 2008 Accepting new patients
Essentia Health Moose Lake CurrentSince May 11, 2023 Accepting new patients
Northern Pines Medical Center CurrentSince Apr 5, 2023 Accepting new patients
Pine Medical Center CurrentSince Jul 13, 2020 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Mar 1, 2020 Accepting new patients
Northern Pines Medical Center CurrentSince Apr 5, 2023 Accepting new patients
Pine Medical Center CurrentSince Jul 13, 2020 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients

Locations

5211 Highway 110
Aurora, MN 55705
Phone (218) 229-1010

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

705 Lundorff Dr
Sandstone, MN 55072
Phone (320) 245-2211

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 12

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 2

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": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1639325863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ESSENTIA HEALTH DULUTH CLINIC SSB-5",
            "address_2": "400 E THIRD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSKA",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "R1704554",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "3718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36091400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639325863",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MILLER",
            "middle_name": "A",
            "credential": "APRN, CNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.