Individual provider Active NPI

Christen M Seidl

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1760063226
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8133 Issued in MN
Practice address
1165 Arcade St
Saint Paul, MN 55106-2615
Phone
(651) 772-5575
Fax
(651) 772-5656
NPI assigned
Apr 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8133 MN
Adult Health Nurse Practitioner 363LA2200X 8133 MN
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 8133 MN Primary

Addresses

Primary practice location

1165 Arcade St
Saint Paul, MN 55106-2615

Mailing address

1165 Arcade St
Saint Paul, MN 55106-2615
Phone (651) 772-5575

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
I20230323002595 MN Practitioner - Nurse Practitioner 9830563311 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus Multi-Specialty CurrentSince Feb 1, 2023 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

121 Washington Ave N
Fl 4
Minneapolis, MN 55401
Phone (404) 992-2702

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1760063226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 ARCADE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551062615",
            "telephone_number": "651-772-5575",
            "fax_number": "888-909-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 ARCADE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551062615",
            "telephone_number": "651-772-5575",
            "fax_number": "651-772-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIDL",
        "first_name": "CHRISTEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2023-12-28",
        "certification_date": "2021-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "8133",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "8133",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.