NPIMap

Individual provider Active NPI

Tetyana Mettler, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1770729337
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
57003 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(952) 967-7977
NPI assigned
Dec 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X PT17682 ND
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 57003 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

Other practice location 1

1200 S. Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-6000

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
I20150513002485 MN Practitioner - Pathology 7719207877 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106
  • Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066
  • Westfields Hospital and Clinic Hospital, New Richmond, WI, CCN 521345
  • Hudson Hospital Hospital, Hudson, WI, CCN 521335
  • Amery Hospital & Clinic Hospital, Amery, WI, CCN 521308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PT17682NDMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Health Services CurrentSince Jun 1, 2015 Accepting new patients
Group Health, Inc. CurrentSince Jul 21, 2025 Accepting new patients
Group Health, Inc. CurrentSince Jul 21, 2025 Accepting new patients
Fairview Express Care Current Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince May 20, 2015 Accepting new patients
Fairview Health Services Clinical Pathology/Laboratory Medicine CurrentSince Jun 1, 2015 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince May 20, 2015 Accepting new patients

Locations

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

420 Delaware St SE
#609
Minneapolis, MN 55455
Phone (612) 624-8133

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

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

400 Stinson Blvd
#2
Minneapolis, MN 55413
Phone (612) 672-2294

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

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

Organizations & group practices 9

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1230681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1770729337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-1891"
        },
        {
            "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": "952-967-7977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 S. Columbia Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "58201",
            "country_code": "US",
            "telephone_number": "701-780-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METTLER",
        "first_name": "TETYANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-31",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "ND",
            "license": "PT17682",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "MN",
            "license": "57003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.