NPIMap

Individual provider Active NPI

Melissa Lynn Gleaves, NP

  • Family Nurse Practitioner
  • Wyoming, MN
National Provider Identifier
1801190244
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R155133-8 Issued in MN
Practice address
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone
(651) 982-7600
NPI assigned
Dec 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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 R155133-8 MN Primary

Addresses

Primary practice location

5200 Fairview Blvd
Wyoming, MN 55092-8013

Mailing address

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7600

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
I20110818000103 MN Practitioner - Nurse Practitioner 7810166378 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

11725 Stinson Ave
Chisago City, MN 55013-9542
Phone (651) 257-8499

Hospital & facility affiliations

  • Accentcare Fairview Home Health - West, LLC Home health agency, Saint Paul, MN, CCN 247078
  • Fairview Lakes Health Services Hospital, Wyoming, MN, CCN 240050
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R155133-8MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Jun 29, 2011 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince Jun 29, 2011 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Oct 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Oct 1, 2020 Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

11725 Stinson Ave
Chisago City, MN 55013
Phone (651) 257-8421

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

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

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

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

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

Interoperability endpoints

  • Direct secure messaging: mgleaves72889@fairview.direct-ci.com

Organizations & group practices 12

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1801190244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928013",
            "telephone_number": "651-982-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928013",
            "telephone_number": "651-982-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEAVES",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R155133-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MN

Sources for this page

Verify at the official NPI Registry.