Steve Mandieka

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP 2097 Issued in MN

Practice address

10800 Lyndale Ave S Ste 114
Bloomington, MN 55420-2611

Phone

(952) 479-0172

Fax

(952) 516-5393

NPI assigned

Apr 17, 2013

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Zandu Health Initiative

  • Student Health Clinic/Center
  • Bloomington, MN
  • NPI 1508302027
  NPD Authorized official

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589068800000",
    "number": "1700229028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 GRANITE DR",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792900",
            "telephone_number": "952-479-0814",
            "fax_number": "952-516-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 LYNDALE AVE S STE 114",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554202611",
            "telephone_number": "952-479-0172",
            "fax_number": "952-516-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDIEKA",
        "first_name": "STEVE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-17",
        "last_updated": "2020-05-10",
        "certification_date": "2020-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 2097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianne Mallison
• Mama KJ Care, Inc
• Nina Magdalen Mancel
• Jeffrey Mandel
• Naomi Renae Manders
• Kayla Mandt
• Josiah Jacob Mangas, DC
• Jean Manlove, LICSW
• Anita Louise Manne, D.C.
• Amanda Manning Hultgren, PHARMD

• Family Nurse Practitioner in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.