Sara Beth Pournoor, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22891 Issued in MN

Practice address

1300 S 2ND St
Minneapolis, MN 55454-1075

Phone

(612) 625-1500

NPI assigned

Sep 28, 2022

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Fairview Express Care

  • Sleep Disorder Diagnostic Clinic/Center
  • Minneapolis, MN
  • NPI 1194143024
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1972227544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S 2ND ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541075",
            "telephone_number": "612-625-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S 2ND ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541075",
            "telephone_number": "612-625-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURNOOR",
        "first_name": "SARA",
        "middle_name": "BETH",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominic Poulin, LPCC
• Emma Pouliot
• Anil K Poulose, MD
• Heidi Joy Pound, DDS
• Jonathan Douglas Pounder, LADC
• Sarah Naomi Poveda, PA-C
• Lesly Jocelyn Powell Sotelo, MSW, LGSW
• Ashley A Powell, CHW
• Caleb Powell, MD
• Charles Powell, OTR/L

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.

Verify at the official NPI Registry.