Active NPI
Shantelle Feragen
- Gerontology Nurse Practitioner
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- R192604-4
- Practice address
- 800 E 28TH St
Minneapolis, MN 55407-3723 - Phone
- (651) 635-9173
- Fax
- (651) 628-2999
- NPI assigned
- Jun 4, 2012
- Last updated
- Mar 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | R192604-4 | MN | Primary |
| Primary Care Nurse Practitioner | 363LP2300X | R32006 | ND |
Addresses
Primary practice location
800 E 28TH St
Minneapolis, MN 55407-3723
Mailing address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-1166
Other practice location 1
1055 Westgate Dr
Suite 100
Saint Paul, MN 55114-1065
Phone (612) 262-7800
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sferagen191667@excellian.direct.allina.com | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 262-8425
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.6 of 100
- Quality
- 72.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.07
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6503 | MN | MD | Chiropractor |
| R192604-4 | MN | MD | Gerontology Nurse Practitioner |
| R32006 | ND | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| NPI 1083910871 | Past | Accepting new patients | |
| Chess Medicine PLLC | Gerontology | Past | Accepting new patients |
Locations
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786
800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547
1055 Westgate Dr
Ste 100
Saint Paul, MN 55114
Phone (612) 262-7800
Organizations & group practices 5
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.
-
dba Allina Health Buffalo Specialty Clinic
- Obstetrics & Gynecology Physician
- Buffalo, MN
- NPI 1295272342
-
dba Allina Health TeleRheumatology
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
-
- NPI 1083910871
-
- Geriatric Medicine (Internal Medicine) Physician
- Montebello, NY
- NPI 1699385021
Gerontology
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Shakopee, MN
- NPI 1578520045
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615939200000",
"number": "1922369115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554071321",
"telephone_number": "612-262-1166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E 28TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073723",
"telephone_number": "651-635-9173",
"fax_number": "651-628-2999"
}
],
"practiceLocations": [
{
"address_1": "1055 Westgate Dr",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551141065",
"country_code": "US",
"telephone_number": "612-262-7800",
"fax_number": "612-262-7022",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FERAGEN",
"first_name": "SHANTELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-04",
"last_updated": "2021-03-17",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MN",
"license": "R192604-4",
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "ND",
"license": "R32006",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sferagen191667@excellian.direct.allina.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/PDF/TXT",
"address_1": "800 E 28th St",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554073723",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.