Individual provider Active NPI

Megan Jeurissen, APRN, CNP

  • Family Nurse Practitioner
  • Shakopee, MN
National Provider Identifier
1992466585
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8912 Issued in MN
Practice address
4201 Dean Lakes Blvd Ste 120
Shakopee, MN 55379-2850
Phone
(952) 496-6700
Fax
(952) 445-6448
NPI assigned
Jan 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8912 MN
Family Nurse Practitioner 363LF0000X 8912 MN Primary

Addresses

Primary practice location

4201 Dean Lakes Blvd Ste 120
Shakopee, MN 55379-2850

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other practice location 1

5320 W 23rd St Ste 130
St Louis Park, MN 55416-1670
Phone (952) 345-8770

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mjeurissen377510@excellian.direct.allina.com Direct

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
I20220127002895 MN Practitioner - Nurse Practitioner 6507258340 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
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)

265 Creek LN S
Jordan, MN 55352-1214
Phone (952) 428-1200

4201 Dean Lakes Blvd
Suite 120
Shakopee, MN 55379-2850
Phone (952) 496-6700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.25 of 100Reported as group
Quality
60.43
Promoting interoperability
83
Improvement activities
40
Cost
79.28

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

State licenses

LicenseStateTypeSpecialty
8912MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Oct 30, 2023 Accepting new patients
St. Francis Regional Medical Center CurrentSince Apr 15, 2024 Accepting new patients
Allina Health System CurrentSince Oct 30, 2023 Accepting new patients
St Francis Regional Medical Center CurrentSince Apr 15, 2024 Accepting new patients
Allina Health System Current Accepting new patients
Lifespark Medical Group, PA Family CurrentSince Jan 4, 2022 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

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

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

4201 Dean Lakes Blvd
Ste 120
Shakopee, MN 55379
Phone (952) 496-6700

5320 W 23rd St
Ste 130
St Louis Park, MN 55416
Phone (952) 345-3213

Interoperability endpoints

  • Direct secure messaging: mjeurissen377510@excellian.direct.allina.com

Organizations & group practices 6

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1992466585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 DEAN LAKES BLVD STE 120",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792850",
            "telephone_number": "952-496-6700",
            "fax_number": "952-445-6448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5320 W 23rd St Ste 130",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554161670",
            "country_code": "US",
            "telephone_number": "952-345-8770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEURISSEN",
        "first_name": "MEGAN",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "8912",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjeurissen377510@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "4201 Dean Lakes Blvd Ste 120",
            "city": "Shakopee",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553792850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.