Individual provider Active NPI

Megan Hydukovich, RDN, LD, CDE

  • Registered Dietitian
  • Hugo, MN
National Provider Identifier
1710446695
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1009655 Issued in MN
Practice address
14688 Everton Ave N
Hugo, MN 55038-6071
Phone
(651) 326-7701
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 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 1009655 MN Primary

Addresses

Primary practice location

14688 Everton Ave N
Hugo, MN 55038-6071

Mailing address

1690 University Ave W Ste 400
Saint Paul, MN 55104-3729

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190418002574 MN Practitioner - Registered Dietitian Or Nutrition Professional 1658613740 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
University of North Dakota School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

10961 Club W Pkwy
Blaine, MN 55449-5866
Phone (763) 572-5700

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

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
91.74
Promoting interoperability
100
Improvement activities
40
Cost
77.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1009655MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Clinics CurrentSince May 1, 2023 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Nov 20, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2021 Accepting new patients
Fairview Clinics CurrentSince May 1, 2023 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Insititue CurrentSince Nov 20, 2021 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

14688 Everton Ave N
Hugo, MN 55038
Phone (651) 326-7701

14688 Everton Ave N
Ste 101
Hugo, MN 55038
Phone (651) 275-4706

2945 Hazelwood St
Ste 320
Maplewood, MN 55109
Phone (612) 273-1172

10961 Club West Pkwy
Minneapolis, MN 55449
Phone (763) 572-5700

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

1690 University Ave W
Ste 370
Saint Paul, MN 55104
Phone (651) 232-5321

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

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

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

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

2945 Hazelwood St
Ste 200
Saint Paul, MN 55109
Phone (612) 440-6315

480 Highway 96 E
Vadnais Heights, MN 55127
Phone (651) 326-5900

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1710446695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 UNIVERSITY AVE W STE 400",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14688 EVERTON AVE N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550386071",
            "telephone_number": "651-326-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDUKOVICH",
        "first_name": "MEGAN",
        "credential": "RDN, LD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "1009655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hugo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.