Individual provider Active NPI

Andrea Laurel Dupre I

  • Psychiatric/Mental Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1679159990
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8801 Issued in MN
Practice address
615 1St Ave NE Ste 310
Minneapolis, MN 55413-2419
Phone
(612) 436-0295
Fax
(612) 436-0163
NPI assigned
Mar 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0808X 2393582 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8801 MN Primary

Addresses

Primary practice location

615 1St Ave NE Ste 310
Minneapolis, MN 55413-2419

Mailing address

615 1St Ave NE Ste 310
Minneapolis, MN 55413-2419
Phone (612) 436-0295

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
I20220208001493 MN Practitioner - Nurse Practitioner 0446643860 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians
Mental Health Counseling Services LLCGroup PAC ID 3173675790, 23 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-7838

615 1St Ave NE
Suite 310
Minneapolis, MN 55413-2419
Phone (612) 436-0295

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jan 12, 2023 Accepting new patients
Mental Health Counseling Services, LLC Single Specialty CurrentSince Jan 21, 2022 Accepting new patients
Fairview Express Care Single Specialty Current Accepting new patients
Fairview Health Services CurrentSince Jan 12, 2023 Accepting new patients
Fairview Health Services Single Specialty CurrentSince Jan 12, 2023 Accepting new patients
Healtheast Medical Research Institute Single Specialty Current Accepting new patients
Fairview Express Care Single Specialty CurrentSince Jan 12, 2023 Accepting new patients
Healtheast Medical Research Institute Single Specialty CurrentSince Jan 12, 2023 Accepting new patients
Fairview Health Services Single Specialty Current Accepting new patients
Healtheast Medical Research Institute Single Specialty CurrentSince Jan 12, 2023 Accepting new patients

Locations

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

615 1st Ave NE
Ste 310
Minneapolis, MN 55413

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

Organizations & group practices 10

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": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1679159990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 1ST AVE NE STE 310",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132419",
            "telephone_number": "612-436-0295",
            "fax_number": "612-436-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 1ST AVE NE STE 310",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132419",
            "telephone_number": "612-436-0295",
            "fax_number": "612-436-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPRE",
        "first_name": "ANDREA",
        "middle_name": "LAUREL",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-18",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MN",
            "license": "2393582",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.