Individual provider Active NPI

Alyssa K Schramm, APRN, CNP

  • Family Nurse Practitioner
  • Maple Grove, MN
National Provider Identifier
1841848801
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6890 Issued in MN
Practice address
9645 Grove Cir N Ste 200
Maple Grove, MN 55369-2684
Phone
(763) 201-8191
Fax
(763) 201-8192
NPI assigned
Sep 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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 6890 MN Primary

Addresses

Primary practice location

9645 Grove Cir N Ste 200
Maple Grove, MN 55369-2684

Mailing address

9645 Grove Cir N Ste 200
Maple Grove, MN 55369-2684
Phone (763) 201-8191

Other names 1

  • Alyssa K Goodew Former name

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
I20191014001145 MN Practitioner - Nurse Practitioner 1850622473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
George Washington University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Interventional Spine and Pain Physicians PAGroup PAC ID 2466606264, 42 clinicians

Practice addresses (Care Compare)

9645 Grove Cir N
Suite 200
Maple Grove, MN 55369-2684
Phone (763) 201-8191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6890MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Spine and Pain Physicians, PA CurrentSince Sep 4, 2019 Accepting new patients

Locations

916 Saint Peter Ave E
Delano, MN 55328
Phone (763) 972-9172

9645 Grove Cir N
Ste 200
Maple Grove, MN 55369
Phone (763) 300-2193

9600 Upland Ln N
Ste 160
Maple Grove, MN 55369

Interoperability endpoints

  • Direct secure messaging: alyssa.goodew@isp.eclinicaldirectplus.com

Organizations & group practices 1

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": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1841848801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIR N STE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692684",
            "telephone_number": "763-201-8191",
            "fax_number": "763-201-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIR N STE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692684",
            "telephone_number": "763-201-8191",
            "fax_number": "763-201-8192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRAMM",
        "first_name": "ALYSSA",
        "middle_name": "K",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "GOODEW",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.