Individual provider Active NPI

Mary Laleen Oothoudt, RD, LD

  • Registered Dietitian
  • Saint Paul, MN
National Provider Identifier
1679139893
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1729 Issued in MN
Practice address
980 Rice St
Saint Paul, MN 55117-4949
Phone
(651) 326-9020
NPI assigned
May 13, 2019
Last updated
Aug 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1729 MN Primary

Addresses

Primary practice location

980 Rice St
Saint Paul, MN 55117-4949

Mailing address

9121 Sequoia Bay
Woodbury, MN 55125-3453
Phone (651) 274-1245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190905001194 MN Practitioner - Registered Dietitian Or Nutrition Professional 8224367917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
University of North Dakota School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

17 Exchange W St
Suite 200
Saint Paul, MN 55102-1222
Phone (651) 326-3600

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1729MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Mar 19, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Mar 19, 2020 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients

Locations

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

17 Exchange St W
Ste 200
Saint Paul, MN 55102
Phone (651) 227-8275

17 Exchange St W
Ste 835
Saint Paul, MN 55102
Phone (651) 232-4200

1983 Sloan Pl
Ste 1
Saint Paul, MN 55117
Phone (651) 326-5700

980 Rice St
Saint Paul, MN 55117
Phone (651) 326-9020

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1679139893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9121 SEQUOIA BAY",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253453",
            "telephone_number": "651-274-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 RICE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551174949",
            "telephone_number": "651-326-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OOTHOUDT",
        "first_name": "MARY",
        "middle_name": "LALEEN",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "1729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.