NPIMap

Individual provider Active NPI

Michelle Kai Ullery, CNP, APRN, DNP

  • Nurse Practitioner
  • Golden Valley, MN
National Provider Identifier
1972824290
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F0610235 Issued in MN
Practice address
3915 Golden Valley Rd
Golden Valley, MN 55422-4249
Phone
(612) 775-2499
NPI assigned
Jun 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R 179417-9 MN
Nurse Practitioner 363L00000X F0610235 MN Primary

Addresses

Primary practice location

3915 Golden Valley Rd
Golden Valley, MN 55422-4249

Mailing address

11809 Ridgemount Ave W
Minnetonka, MN 55305-1204
Phone (763) 226-4520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921001475 MN Practitioner - Nurse Practitioner 2961528476 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

800 E 28TH St
Suite 1750
Minneapolis, MN 55407-3723
Phone (612) 863-4495

Hospital & facility affiliations

  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 179417-9MNMDRegistered Nurse
F0610235MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Feb 1, 2016 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jun 1, 2013 Accepting new patients
Allina Health System Past Accepting new patients

Locations

800 E 28th St
Ste 1750
Minneapolis, MN 55407
Phone (612) 863-4495

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

3915 Golden Valley Rd
Minneapolis, MN 55422
Phone (612) 588-0811

1021 Bandana Blvd E
Ste 100
Saint Paul, MN 55108
Phone (877) 414-2533

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

1460 Curve Crest Blvd W
Stillwater, MN 55082
Phone (651) 241-3820

Interoperability endpoints

  • Direct secure messaging: mullery191277@excellian.direct.allina.com

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 and National Provider Directory roles.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1972824290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11809 RIDGEMOUNT AVE W",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051204",
            "telephone_number": "763-226-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224249",
            "telephone_number": "612-775-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLERY",
        "first_name": "MICHELLE",
        "middle_name": "KAI",
        "name_prefix": "Mrs.",
        "credential": "CNP,  APRN, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R 179417-9",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "F0610235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.