NPIMap

Individual provider Active NPI

Elana Nack, M.D.

  • Radiation Oncology Physician
  • Saint Paul, MN
National Provider Identifier
1720432255
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
69485 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-2039
Fax
(651) 254-9333
NPI assigned
Apr 21, 2016
Last updated
Nov 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 69485 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

7401 Metro Blvd Ste 210
Edina, MN 55439-3086
Phone (952) 920-4915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210901003456 MN Practitioner - Radiation Oncology 4789940750 Reassigns benefits to 1 organization
I20230118000623 WI Practitioner - Radiation Oncology 4789940750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minneapolis Radiation Oncology PAGroup PAC ID 8527951094, 18 clinicians

Practice addresses (Care Compare)

501 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2950

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-2039

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
69485MNMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Minneapolis Radiation Oncology PA Radiation Oncology CurrentSince Sep 13, 2021 Accepting new patients
Regions Hospital Past Accepting new patients
Mid-Minnesota Radiation Oncology, PA Radiation Oncology Past Accepting new patients

Locations

215 Ivy St
Brainerd, MN 56401
Phone (218) 828-7585

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

11850 Blackfoot St NW
Ste 150
Coon Rapids, MN 55433
Phone (763) 433-0221

550 Osborne Rd NE
Minneapolis, MN 55432
Phone (763) 236-3800

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

7401 Metro Blvd
Ste 210
Minneapolis, MN 55439
Phone (952) 920-4915

3435 W Broadway Ave
Robbinsdale, MN 55422
Phone (763) 520-7887

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

640 Jackson St
Stop 11202E
Saint Paul, MN 55101

1475 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2031

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

560 S Maple St
Ste 10
Waconia, MN 55387
Phone (952) 442-6000

501 Hospital Rd
New Richmond, WI 54017
Phone (715) 243-2950

Interoperability endpoints

  • Direct secure messaging: enack276413@direct.healthpartners.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1720432255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 METRO BLVD STE 210",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554393086",
            "telephone_number": "952-920-4915",
            "fax_number": "952-915-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-2039",
            "fax_number": "651-254-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACK",
        "first_name": "ELANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MN",
            "license": "69485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.