Active NPI
Selena Marie Dacosta, APRN, CNP
- Nurse Practitioner
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5532
- Practice address
- 715 S 8TH St
Minneapolis, MN 55404-1210 - Phone
- (612) 873-6963
- NPI assigned
- Feb 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5532 | MN | Primary |
Addresses
Primary practice location
715 S 8TH St
Minneapolis, MN 55404-1210
Mailing address
701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000
Other practice location 1
701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963
Hospital & facility affiliations
- Hennepin County Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.67 of 100
- Quality
- 74.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.86
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5532 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hennepin Healthcare System Inc | Current | Accepting new patients | |
| Hennepin Healthcare System, Inc | Current | Accepting new patients |
Locations
715 S 8th St
Minneapolis, MN 55404
Phone (612) 873-6010
701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005
701 Park Ave
#350
Minneapolis, MN 55415
Phone (612) 873-5334
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.
-
- Rehabilitation Hospital Unit
- Minneapolis, MN
- NPI 1033138136
-
- Specialty Pharmacy
- Minneapolis, MN
- NPI 1619567625
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1407897309
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696982400000",
"number": "1669973962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 PARK AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151623",
"telephone_number": "612-873-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 S 8TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554041210",
"telephone_number": "612-873-6963"
}
],
"practiceLocations": [
{
"address_1": "701 Park Ave",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554151623",
"country_code": "US",
"telephone_number": "612-873-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DACOSTA",
"first_name": "SELENA",
"middle_name": "MARIE",
"credential": "APRN, CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-22",
"last_updated": "2023-10-11",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "5532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.