Individual provider Active NPI

Dana Alexandra Peterson, APRN

  • Family Nurse Practitioner
  • Maplewood, MN
National Provider Identifier
1902294358
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6699 Issued in MN
Practice address
1747 Beam Ave Ste 100
Maplewood, MN 55109-1128
Phone
(651) 232-3900
NPI assigned
Jan 7, 2015
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6699 MN Primary
Neurological Surgery Physician 207T00000X 6699 MN
Nurse Practitioner 363L00000X 6046 CT
Family Nurse Practitioner 363LF0000X RN2284104 MA
Family Nurse Practitioner 363LF0000X 6046 CT

Addresses

Primary practice location

1747 Beam Ave Ste 100
Maplewood, MN 55109-1128

Mailing address

400 Stinson Blvd FL 2
Minneapolis, MN 55413-2614

Other practice location 1

1700 University Ave W Fl 6
Saint Paul, MN 55104-3727
Phone (651) 232-2273

Other practice location 2

41 Mall Rd
Lahey Hospital and Medical Center
Burlington, MA 01805-0001
Phone (781) 744-7580

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
I20190718000212 MN Practitioner - Nurse Practitioner 9638487325 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

1700 University Ave W
6TH Floor W
Saint Paul, MN 55104-3727
Phone (651) 232-2273

3305 Central Park Village Dr
Eagan, MN 55121-7707

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6046CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 22, 2019 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Nov 1, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 22, 2019 Accepting new patients
Fairview Express Care CurrentSince Nov 1, 2020 Accepting new patients
Fairview Health Services Past Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients

Locations

1747 Beam Ave
Ste 100
Maplewood, MN 55109
Phone (651) 221-9051

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

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

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

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

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: dpeterson600793@fairview.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1902294358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 STINSON BLVD FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 BEAM AVE STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091128",
            "telephone_number": "651-232-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 University Ave W Fl 6",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551043727",
            "country_code": "US",
            "telephone_number": "651-232-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 Mall Rd",
            "address_2": "Lahey Hospital and Medical Center",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018050001",
            "country_code": "US",
            "telephone_number": "781-744-7580",
            "fax_number": "781-744-5778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DANA",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Miss",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6699",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MN",
            "license": "6699",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "6046",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2284104",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.