NPIMap

Individual provider Active NPI

Danielle Bandholz

  • Gerontology Nurse Practitioner
  • Edina, MN
National Provider Identifier
1730555889
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
CNP3693 Issued in MN
Practice address
3400 W 66TH St
Suite 290
Edina, MN 55435-2111
Phone
(952) 924-8117
NPI assigned
Aug 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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 CNP3693 MN Primary

Addresses

Primary practice location

3400 W 66TH St
Suite 290
Edina, MN 55435-2111

Mailing address

15620 Falcon Cir N
Hugo, MN 55038-8204
Phone (651) 707-4697

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
I20151112000114 MN Practitioner - Nurse Practitioner 9931419553 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (855) 324-7843

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP3693MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Oct 10, 2015 Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Dec 11, 2020 Accepting new patients
Fairview Specialty Services CurrentSince Dec 11, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Feb 29, 2016 Accepting new patients
Healtheast Medical Research Institute CurrentSince Feb 29, 2016 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Clinics CurrentSince Oct 10, 2015 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

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

3400 W 66th St
Ste 290
Minneapolis, MN 55435
Phone (952) 836-3637

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

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

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

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

1390 University Ave W
Saint Paul, MN 55104
Phone (651) 232-4800

Interoperability endpoints

  • Direct secure messaging: dbandholz344576@fairview.direct-ci.com

Organizations & group practices 11

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 4

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": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1730555889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15620 FALCON CIR N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550388204",
            "telephone_number": "651-707-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST",
            "address_2": "SUITE 290",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352111",
            "telephone_number": "952-924-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDHOLZ",
        "first_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "CNP3693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.