NPIMap

Individual provider Active NPI

Rebecca Ann Schaefer, NP-C

  • Gerontology Nurse Practitioner
  • Golden Valley, MN
National Provider Identifier
1700218211
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R177347-5 Issued in MN
Practice address
1415 Lilac Dr N Ste 190
Golden Valley, MN 55422
Phone
(763) 267-8701
Fax
(763) 231-9602
NPI assigned
Aug 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R177347-5 MN Primary

Addresses

Primary practice location

1415 Lilac Dr N Ste 190
Golden Valley, MN 55422

Mailing address

1415 Lilac Dr N Ste 190
Golden Valley, MN 55422-4544
Phone (763) 267-8701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130827000749 MN Practitioner - Nurse Practitioner 4385887132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Twin Cities Physicians Professional CorporationGroup PAC ID 9830499763, 66 clinicians

Practice addresses (Care Compare)

1415 Lilac Dr N
Suite 190
Golden Valley, MN 55422-4544
Phone (763) 267-8701

Hospital & facility affiliations

  • Adara Home Health Inc Home health agency, Buffalo, MN, CCN 248056
  • Vivie Home Health Home health agency, Alexandria, MN, CCN 248096
  • Home Health Care Inc Home health agency, Golden Valley, MN, CCN 248037
  • Healthpartners Hospice and Palliatice Care Hospice, Bloomington, MN, CCN 241520
  • Grace Hospice Hospice, Minneapolis, MN, CCN 241595
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

Merit-based Incentive Payment System (MIPS)

Final score
86.11 of 100Reported as group
Quality
70.97
Improvement activities
40
Cost
73.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R177347-5MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Cities Physicians Professional Corporation CurrentSince Jul 8, 2019 Accepting new patients

Locations

1415 Lilac Dr N
Ste 190
Minneapolis, MN 55422
Phone (763) 267-8701

Organizations & group practices 1

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1700218211",
    "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": "55422",
            "telephone_number": "763-267-8701",
            "fax_number": "763-231-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R177347-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.