Mehret Medhanie, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

5815 Issued in MN

Practice address

1415 Lilac Dr N Ste 190
Golden Valley, MN 55422-4544

Phone

(763) 267-8701

Fax

(763) 231-9602

NPI assigned

Jun 13, 2018

Last updated

Feb 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Side Community Health Services, Inc.Group PAC ID 2062306434, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmedhanie799663@direct.ochin.org
• Direct secure messaging: ms_mmedhani@landmarkhealth-direct.org

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.

• West Side Community Health Services, Inc.

  dba McDonough Homes Clinic

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1821149964
  Medicare reassignment Care Compare group NPD
• West Side Community Health Services, Inc.

  dba MINNESOTA COMMUNITY CARE MBC - St. Paul

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1043187289
  NPD
• West Side Community Health Services, Inc.

  dba East Side Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1427106871
  NPD

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1649763780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701",
            "fax_number": "763-231-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701",
            "fax_number": "763-231-9602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8300 Norman Center Dr Ste 230",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554371050",
            "country_code": "US",
            "telephone_number": "866-949-0108",
            "fax_number": "901-422-7636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDHANIE",
        "first_name": "MEHRET",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "5815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Michael McManus, LMFT
• Julie A McMonagle, LICSW
• Kimberly Nicole McNally, DNP, CNM, FNP-C
• Ryan Michael Meade, MS, LPCC
• Meadow Ridge Senior Living
• Medicare Home Care
• Medlab Inc
• Medway Support Services. LLC (Medway)
• Meisa Transportation Services, LLC
• Paul Larry Melsness, MSPT

• Gerontology Nurse Practitioner in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.