Active NPI
Tyrolt A Ngole, CNP, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Coon Rapids, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 9694
- Practice address
- 11660 Round Lake Blvd NW
Coon Rapids, MN 55433-2638 - Phone
- (763) 767-3350
- NPI assigned
- Nov 15, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 9694 | MN | Primary |
Addresses
Primary practice location
11660 Round Lake Blvd NW
Coon Rapids, MN 55433-2638
Mailing address
11660 Round Lake Blvd NW
Coon Rapids, MN 55433-2638
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
- Certified Clinical Nurse Specialist (CNS)
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
11660 Round Lake Blvd NW
Coon Rapids, MN 55433-2638
Phone (763) 767-3350
1900 Silver Lake NWRD
Suite 110
New Brighton, MN 55112-1789
1900 Silver Lake Rd NW
New Brighton, MN 55112-1789
Phone (651) 628-9566
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aligned Synergy Mental Health Services | Current | Accepting new patients | |
| Nystrom & Associates, LTD | Current | Accepting new patients |
Locations
13750 Crosstown Dr NW
Ste 108
Andover, MN 55304
Phone (763) 205-2579
11660 Round Lake Blvd NW
Coon Rapids, MN 55433
Phone (763) 317-0718
1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718
1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704
Organizations & group practices 2
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.
-
dba Sagent Behavioral Health
- Clinical Social Worker
- New Brighton, MN
- NPI 1396750188
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Brooklyn Park, MN
- NPI 1063173508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668988800000",
"number": "1952019374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11660 ROUND LAKE BLVD NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554332638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11660 ROUND LAKE BLVD NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554332638",
"telephone_number": "763-767-3350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGOLE",
"first_name": "TYROLT",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "CNP, PMHNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-15",
"last_updated": "2022-11-21",
"certification_date": "2022-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MN",
"license": "9694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.