Jennifer L Sisell

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

6715 Issued in MN

Practice address

1415 Lilac Dr N Ste 190
Golden Valley, MN 55422-4544

Phone

(763) 267-8701

Fax

(763) 231-9602

NPI assigned

Jul 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI, SD, ND4 enrollments

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 4

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Villagehealth DM LLCGroup PAC ID 2769812445, 161 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Villagehealth DM LLC

  • Case Management Agency
  • Denver, CO
  • NPI 1598273211

  MN, ND, SD, WI

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1861046898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701",
            "fax_number": "763-231-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701",
            "fax_number": "763-231-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISELL",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "6715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Potter Simonsen, L.P.C.C
• Brook Simonson, RN
• Devika Singh
• Amanda Louise Singleton, PTA
• Jillian Sirany
• Michael Sitzman, PHARMD.
• Lois C Sjogren, CBPMM
• Brooke Skinner-Drawz, LICSW, PHD
• Hans Carl Skulstad, LMFT
• Jennie Louise Gorres Skulstad, M.S, LMFT

• Gerontology Nurse Practitioner in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.