Individual provider Active NPI

Tegist Ayalew, FNP

  • Family Nurse Practitioner
  • Roseville, MN
National Provider Identifier
1972991354
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3108 Issued in MN
Practice address
1515 County B Rd W
Roseville, MN 55113
Phone
(651) 523-9800
Fax
(651) 523-9801
NPI assigned
Jan 7, 2015
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3108 MN Primary

Addresses

Primary practice location

1515 County B Rd W
Roseville, MN 55113

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150929000467 MN Practitioner - Nurse Practitioner 1759699580 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Primary Care Minnesota PLLCGroup PAC ID 2163945460, 30 clinicians
Minuteclinic Diagnostic of Minnesota PAGroup PAC ID 7810289949, 83 clinicians
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

1515 County Rd B W
Roseville, MN 55113-6005
Phone (866) 389-2727

2165 White Bear Ave
Maplewood, MN 55109-2707
Phone (651) 523-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3108MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care Minnesota PLLC Family CurrentSince Oct 9, 2025 Accepting new patients
Sama Healthcare CurrentSince Dec 17, 2016 Accepting new patients
Minuteclinic Diagnostic of Minnesota, P.a. Family CurrentSince Oct 9, 2025 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Sep 12, 2022 Accepting new patients
Group Health Plan, Inc. CurrentSince Sep 12, 2022 Accepting new patients

Locations

1010 W Lake St
Minneapolis, MN 55408
Phone (612) 822-1297

1500 109th Ave NE
Minneapolis, MN 55449
Phone (763) 354-1000

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

2330 Central Ave NE
Minneapolis, MN 55418
Phone (612) 781-1212

4730 Chicago Ave
Minneapolis, MN 55407
Phone (612) 313-0000

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

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

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

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

1515 County Road B W
Saint Paul, MN 55113
Phone (651) 631-0330

2165 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 523-9800

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19405/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1972991354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 COUNTY B RD W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-523-9800",
            "fax_number": "651-523-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYALEW",
        "first_name": "TEGIST",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "3108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.