Michael Russell Neutkens, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

480 Osborne Rd NE
Fridley, MN 55432-2773

Phone

(763) 785-4500

NPI assigned

Jul 8, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

R Franklin University of Med & Sci/Chicago Medical School, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mneutkens127927@direct.northmemorial.com

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.

• North Memorial Health Care

  dba North Memorial Health Hospital

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Medicare reassignment Care Compare group
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552
  NPD
• North Memorial Health Care

  dba North Memorial Health Specialty Clinic

  • Medical Specialty Clinic/Center
  • Robbinsdale, MN
  • NPI 1871927715
  NPD

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1750722617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 OSBORNE RD NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 OSBORNE RD NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322773",
            "telephone_number": "763-785-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUTKENS",
        "first_name": "MICHAEL",
        "middle_name": "RUSSELL",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-08",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Elizabeth Nelson, PA-C
• Judith M. Nelson, RN, CNS
• Nicole E Nelson, PHARMD, BCPS
• Neopath
• Mary Rose Nettleton, LICSW
• Rena Nevels
• Naomi Mehn Ngaima, PHARMD
• Camanh Nguyen, PHARMD
• Colette Ngum Ngwa, REGISTERED NURSE
• Gene M Nisja, LMFT

• Physician Assistant in Fridley, MN
• Providers in Fridley, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.