Individual provider Active NPI

Ramona L Lisowski, AGNP-BC

  • Family Nurse Practitioner
  • Roseville, MN
National Provider Identifier
1851119713
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11365 Issued in MN
Practice address
2780 Snelling Ave N Ste 304
Roseville, MN 55113-7125
Phone
(651) 433-7255
Fax
(651) 888-2611
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 11365 MN Primary

Addresses

Primary practice location

2780 Snelling Ave N Ste 304
Roseville, MN 55113-7125

Mailing address

2780 Snelling Ave N Ste 304
Roseville, MN 55113-7125
Phone (651) 433-7255

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
I20250415001582 MN Practitioner - Nurse Practitioner 1850816612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Institute for Pain Management, LLCGroup PAC ID 1951584143, 2 clinicians

Practice addresses (Care Compare)

2780 Snelling N Ave
Suite 304
Roseville, MN 55113-7125
Phone (651) 815-8155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Institute for Pain Management, LLC CurrentSince Jan 12, 2025 Accepting new patients

Locations

2780 Snelling Ave N
Ste 304
Saint Paul, MN 55113
Phone (651) 815-8155

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": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1851119713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 SNELLING AVE N STE 304",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551137125",
            "telephone_number": "651-433-7255",
            "fax_number": "651-888-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 SNELLING AVE N STE 304",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551137125",
            "telephone_number": "651-433-7255",
            "fax_number": "651-888-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISOWSKI",
        "first_name": "RAMONA",
        "middle_name": "L",
        "credential": "AGNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "11365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.