Individual provider Active NPI

Tanya Lynn Velishek, MSN, RN, PHN, PNP-PC

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1770937781
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
CNP 4496 Issued in MN
Practice address
2535 University Ave SE
Minneapolis, MN 55414-3205
Phone
(612) 672-2350
NPI assigned
Apr 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X CNP 4496 MN Primary

Addresses

Primary practice location

2535 University Ave SE
Minneapolis, MN 55414-3205

Mailing address

845 Hickory PL
Jordan, MN 55352-1858
Phone (612) 275-4416

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
I20160517001485 MN Practitioner - Nurse Practitioner 9830488766 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Sep 19, 2021 Accepting new patients
Fairview Health Services CurrentSince Sep 19, 2021 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Sep 19, 2021 Accepting new patients
Fairview Health Services CurrentSince Sep 19, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care CurrentSince Sep 19, 2021 Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

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

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

2535 University Ave SE
Minneapolis, MN 55414
Phone (612) 672-2350

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

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

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

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

Interoperability endpoints

  • Direct secure messaging: tvelishek88278@fairview.direct-ci.com

Organizations & group practices 10

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": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1770937781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 HICKORY PL",
            "city": "JORDAN",
            "state": "MN",
            "postal_code": "553521858",
            "telephone_number": "612-275-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 UNIVERSITY AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143205",
            "telephone_number": "612-672-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELISHEK",
        "first_name": "TANYA",
        "middle_name": "LYNN",
        "credential": "MSN, RN, PHN, PNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-15",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "CNP 4496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.