Shannon Rose Petroske, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP4645 Issued in MN

Practice address

750 E 34TH St
Hibbing, MN 55746-2341

Phone

(218) 362-6898

NPI assigned

Jul 13, 2016

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

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Range Regional Health ServicesGroup PAC ID 8022920024, 349 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Range Regional Health Services Hospital, Hibbing, MN, CCN 240040
• Grand Itasca Clinic and Hospital Hospital, Grand Rapids, MN, CCN 240064
• Essentia Health Virginia Hospital, Virginia, MN, CCN 240084

Merit-based Incentive Payment System (MIPS)

Final score

92.35 of 100Reported as group

Quality

88.69

Promoting interoperability

100

Improvement activities

40

Cost

76.65

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spetroske294224@fairview.direct-ci.com

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.

• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265
  Medicare reassignment Care Compare group NPD
• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631
  Medicare reassignment NPD
• Grand Itasca Clinic and Hospital

  • Community/Retail Pharmacy
  • Grand Rapids, MN
  • NPI 1225441157
  NPD
• Range Regional Health Services

  • Durable Medical Equipment & Medical Supplies
  • International Falls, MN
  • NPI 1710954821
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631
  Care Compare affiliation Name & address match
• Essentia Health Virginia, LLC

  • General Acute Care Hospital
  • Virginia, MN
  • NPI 1083617120
  Care Compare affiliation
• Range Regional Health Services

  • General Acute Care Hospital
  • Hibbing, MN
  • NPI 1356321699
  Care Compare affiliation

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1962854075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3429 OUTER DRIVE",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "55746",
            "telephone_number": "218-750-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E 34TH ST",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462341",
            "telephone_number": "218-362-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSKE",
        "first_name": "SHANNON",
        "middle_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP4645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie M Perkovich, LPCC
• Cheryl Marie Perpich, NCTMB
• Stephanie Anne Peterson, PHARMD
• Craig M Petroske
• Jennifer Petroske, PHARMD
• Gina Marie Pettinari, CRNA
• Kimberly Dawn Pettinelli, NP
• PJ Noss LLC
• Bernadette J Pospeck, MSW, LICSW
• Richard A Pounds, MD

• Family Nurse Practitioner in Hibbing, MN
• Providers in Hibbing, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; 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.