Individual provider Active NPI

Tina McLean, CNP

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1720027113
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2005005527 Issued in MN
Practice address
2001 Blaisdell Ave
Minneapolis, MN 55404-2414
Phone
(952) 993-8000
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R138246-8 MN
Family Nurse Practitioner 363LF0000X 2005005527 MN Primary

Addresses

Primary practice location

2001 Blaisdell Ave
Minneapolis, MN 55404-2414

Mailing address

8170 33Rd Ave S
PO Box 1309 Mail Stop 21110Q
Minneapolis, MN 55425-4516

Other identifiers 1

IdentifierTypeStateIssuer
D85063OtherMNMHI PROVIDER NUMBER

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
I20061211000167 MN Practitioner - Nurse Practitioner 1850390311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

2001 Blaisdell Ave
Minneapolis, MN 55404-2414
Phone (952) 993-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3369MNMDChiropractor
R138246-8MNMDRegistered Nurse
2005005527MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Apr 25, 2016 Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Apr 25, 2016 Accepting new patients
Park Nicollet Clinic Current Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

2001 Blaisdell Ave
Minneapolis, MN 55404
Phone (952) 993-8000

Organizations & group practices 3

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1720027113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "PO BOX 1309 MAIL STOP 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BLAISDELL AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042414",
            "telephone_number": "952-993-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "TINA",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R138246-8",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "2005005527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHI PROVIDER NUMBER",
            "identifier": "D85063",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.