NPIMap

Individual provider Active NPI

Randy Wayne Peterson, APRN, CNP

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1730747221
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7781 Issued in MN
Practice address
800 E 28TH St # W4300
Minneapolis, MN 55407-3723
Phone
(612) 863-3110
Fax
(612) 863-8927
NPI assigned
May 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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 R214182-8 MN
Nurse Practitioner 363L00000X 7781 MN Primary

Addresses

Primary practice location

800 E 28TH St # W4300
Minneapolis, MN 55407-3723

Mailing address

PO Box 43
Minneapolis, MN 55440-0043
Phone (612) 262-1166

Other practice location 1

716 South 7th Street
P1.600
Minneapolis, MN 55415
Phone (612) 873-3000

Other practice location 2

6545 France Ave S Ste 586
Edina, MN 55435-2125
Phone (952) 915-8700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rpeterson196090@excellian.direct.allina.com Direct

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
I20201125000062 MN Practitioner - Nurse Practitioner 9830500701 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Minnesota Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

225 Smith Ave N
Suite 300
St Paul, MN 55102-2592
Phone (651) 241-5000

6525 France Ave S
Suite 200
Edina, MN 55435-2176
Phone (952) 848-8890

800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 863-4762

Hospital & facility affiliations

  • Favoured Hospice, LLC Hospice, Dayton, MN, CCN 241617
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078
  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038
  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
74.5
Promoting interoperability
100
Improvement activities
40
Cost
72.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R214182-8MNMDRegistered Nurse
7781MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Nurse Practitioner CurrentSince Jan 3, 2026 Accepting new patients
Fairview Express Care CurrentSince Mar 29, 2024 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Dec 1, 2020 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Dec 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Mar 29, 2024 Accepting new patients
Allina Health System CurrentSince Aug 28, 2023 Accepting new patients
Fairview Health Services CurrentSince Jan 3, 2026 Accepting new patients
Allina Health System CurrentSince Feb 7, 2026 Accepting new patients
Allina Health System CurrentSince Aug 28, 2023 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients
Allina Health System Current Accepting new patients
Fairview Express Care Current Accepting new patients
Allina Health System Past Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

6001 96th Ln N
Ste 100
Brooklyn Park, MN 55445

6545 France Ave S
Ste 586
Edina, MN 55435
Phone (952) 915-8770

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

2800 Chicago Ave
Ste 400
Minneapolis, MN 55407
Phone (612) 863-3110

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

800 E 28th St
#W4300
Minneapolis, MN 55407
Phone (612) 863-3110

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

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

6525 France Ave S
Ste 200
Minneapolis, MN 55435
Phone (952) 848-8890

8100 W 78th St
Ste 230
Minneapolis, MN 55439
Phone (888) 892-7575

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

2805 Campus Dr
Ste 465
Plymouth, MN 55441
Phone (763) 577-7400

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

225 Smith Ave N
Ste 300
Saint Paul, MN 55102
Phone (651) 241-5000

255 Smith Ave N
Ste 210
Saint Paul, MN 55102
Phone (651) 241-4928

310 Smith Ave N
Ste 300
Saint Paul, MN 55102
Phone (651) 241-5111

Interoperability endpoints

  • Direct secure messaging: rpeterson196090@excellian.direct.allina.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1730747221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST # W4300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-3110",
            "fax_number": "612-863-8927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "716 South 7th Street",
            "address_2": "P1.600",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55415",
            "country_code": "US",
            "telephone_number": "612-873-3000",
            "fax_number": "612-873-1946",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6545 France Ave S Ste 586",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352125",
            "country_code": "US",
            "telephone_number": "952-915-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RANDY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R214182-8",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "7781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpeterson196090@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "800 E 28th St",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554073723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.