Individual provider Active NPI

Sivilai Vang, FNP-BC

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1790327781
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7001 Issued in MN
Practice address
1239 Payne Ave
Saint Paul, MN 55130-3667
Phone
(651) 209-8350
NPI assigned
Oct 11, 2019
Last updated
Oct 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7001 MN Primary

Addresses

Primary practice location

1239 Payne Ave
Saint Paul, MN 55130-3667

Mailing address

313 Minnesota Ave
Roseville, MN 55113-4741
Phone (651) 209-8350

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL St.PaulFamilyMedicalCenter Health Information Exchange (HIE)

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
I20200513001770 MN Practitioner - Nurse Practitioner 3577994276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1789 Woodlane Dr
Suite a
Woodbury, MN 55125-3910
Phone (612) 444-3000

2428 E 117TH St
Burnsville, MN 55337-1269
Phone (612) 444-3000

2440 E 117TH St
Burnsville, MN 55337-1269
Phone (651) 331-8478

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7001MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Pain Relief and Wellness Center, PLLC CurrentSince May 8, 2020 Accepting new patients
Valley Pain Relief and Wellness Center, PLLC CurrentSince May 8, 2020 Accepting new patients

Locations

2428 E 117th St
Burnsville, MN 55337

2440 E 117th St
Burnsville, MN 55337
Phone (651) 331-8478

2847 Johnson St NE
Minneapolis, MN 55418
Phone (612) 789-7277

3224 6th Ave NE
Unit B
Rochester, MN 55906

1789 Woodlane Dr
Ste A
Woodbury, MN 55125

Interoperability endpoints

  • Direct secure messaging: vang.sivilai.003.0230015@vprwc.meditab.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1790327781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 MINNESOTA AVE",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134741",
            "telephone_number": "651-209-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 PAYNE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551303667",
            "telephone_number": "651-209-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "SIVILAI",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "St.PaulFamilyMedicalCenter",
            "affiliation": "N",
            "endpointDescription": "St.Paul Family Medical Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "St.Paul Family Medical Center",
            "address_1": "1239 Payne Ave",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551303667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.