Active NPI
New Hope Crystal Medical Clinic
- Family Medicine Physician
- Crystal, MN
National Provider Identifier
1841253366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- NEW HOPE CRYSTAL MEDICAL CLINIC
- Practice address
- 3501 Douglas Dr N
Crystal, MN 55422-2415 - Phone
- (763) 535-9601
- Fax
- (763) 535-5601
- NPI assigned
- Apr 7, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Art Fretag
- Title
- Business Manager
- Phone
- (763) 535-9601
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
3501 Douglas Dr N
Crystal, MN 55422-2415
Mailing address
3501 Douglas Dr N
Crystal, MN 55422-2415
Phone (763) 535-9601
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005733572 | Other | MN | AETNA |
| 30310462 | Other | MN | METROPOLITAN HEALTH PLAN |
| 97421NO | Other | MN | BLUES |
| P044 | Other | MN | UCARE |
| 93495050569001 | Other | MN | PREFERRED ONE |
| 2092 | Other | MN | HEALTHPARTNERS |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Elk River, MN
- NPI 1437246808
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144368000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1841253366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3501 DOUGLAS DR N",
"city": "CRYSTAL",
"state": "MN",
"postal_code": "554222415",
"telephone_number": "763-535-9601",
"fax_number": "763-535-5601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 DOUGLAS DR N",
"city": "CRYSTAL",
"state": "MN",
"postal_code": "554222415",
"telephone_number": "763-535-9601",
"fax_number": "763-535-5601"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW HOPE CRYSTAL MEDICAL CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-07",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "FRETAG",
"authorized_official_first_name": "ART",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "763-535-9601"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0005733572",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "METROPOLITAN HEALTH PLAN",
"identifier": "30310462",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUES",
"identifier": "97421NO",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "P044",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "93495050569001",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "2092",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Crystal, MN
- N&V Helpful Heart Care Inc,
- Jaslyn Nabors
- Comfort Lumyedang Nchanji, MD
- Jennifer Nelson, NP
- William George Nelson, MD
- Jon S Nielsen, MD
- North Clinic, PA (North Clinic - Robbinsdale)
- North Clinic, PA (Voyage Healthcare)
- Northwest Family Physicians PA (Northwest Family Clinics)
- Northwoods Spine Instsitute, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.