NPIMap

Individual provider Active NPI

Stephanie Koivisto

  • Family Nurse Practitioner
  • Hibbing, MN
National Provider Identifier
1992163554
Registry record updated Feb 10, 2016
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Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4230 Issued in MN
Practice address
990 W 41St St
Hibbing, MN 55746-3045
Phone
(218) 263-9698
NPI assigned
Feb 10, 2016
Sex
Female
Sole proprietor
No

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 30

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

View all 30

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Range Regional Health Services 349 clinicians

Practice addresses (Care Compare)

750 E 34TH St
Hibbing, MN 55746-4600
Phone (218) 262-4881

Hospital & facility affiliations

  • Aveanna Home Health Home health agency, Hibbing, MN, CCN 247218
  • Range Regional Health Services Home health agency, Hibbing, MN, CCN 247183
  • Range Regional Health Services Hospital, Hibbing, MN, CCN 240040
  • Grand Itasca Clinic and Hospital Hospital, Grand Rapids, MN, CCN 240064
  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047

Merit-based Incentive Payment System (MIPS)

Final score
96.93 of 100Reported as group
Quality
94.88
Promoting interoperability
100
Improvement activities
40
Cost
78.21

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20160817002685 MN Practitioner - Nurse Practitioner 2961797741 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4230MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Range Regional Health Services CurrentSince Aug 1, 2016 Accepting new patients
Range Regional Health Services Current Accepting new patients
Range Regional Health Services CurrentSince Aug 1, 2016 Accepting new patients

Locations

1814 14th Ave E
Hibbing, MN 55746
Phone (218) 262-3441

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

3605 Mayfair Ave
Hibbing, MN 55746
Phone (218) 262-3441

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4230 MN Primary

Addresses

NPPES NPI Registry

Primary practice location

990 W 41St St
Hibbing, MN 55746-3045

Mailing address

30445 Hwy 65
Pengilly, MN 55775

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 10, 2016.

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1992163554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30445 HWY 65",
            "city": "PENGILLY",
            "state": "MN",
            "postal_code": "55775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W 41ST ST",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557463045",
            "telephone_number": "218-263-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOIVISTO",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "4230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hibbing, MN

Sources for this page

Verify at the official NPI Registry.