Mrs Tracy Mindiola, RD in Maple Grove, MN - Medicare Dietitian, Registered Provider

Mrs Tracy Mindiola, RD is a medicare enrolled "Dietitian, Registered" provider in Maple Grove, Minnesota. Her current practice location is 12488 74th Ave N, Maple Grove, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 267-2015.

Mrs Tracy Mindiola is licensed to practice in Minnesota (license number 4379) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1457084154.

Contact Information

	Mrs Tracy Mindiola, RD
	12488 74th Ave N, Maple Grove, MN 55369-5285
	(763) 267-2015
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Tracy Mindiola
Gender	Female
Speciality	Dietitian, Registered
Location	12488 74th Ave N, Maple Grove, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457084154
Provider Enumeration Date: 07/08/2022
Last Update Date: 09/12/2023

Medicare PECOS Information:

PECOS PAC ID: 3779939061
Enrollment ID: I20231023002221

Medical Identifiers

Medical identifiers for Mrs Tracy Mindiola such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457084154	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	4379 (Minnesota)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Tracy Mindiola allows following entities to bill medicare on her behalf.

Provider Name	Persevere Wellness Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1003544602 PECOS PAC ID: 2860848157 Enrollment ID: O20231023002126

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Tracy Mindiola is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Tracy Mindiola, RD 12488 74th Ave N, Maple Grove, MN 55369-5285 Ph: (763) 267-2015	Mrs Tracy Mindiola, RD 12488 74th Ave N, Maple Grove, MN 55369-5285 Ph: (763) 267-2015

Reviews and Comments

Dietitian, Registered in Maple Grove, MN

Persevere Wellness Llc Dietitian Medicare: Medicare Enrolled Practice Location: 12488 74th Ave N, Maple Grove, MN 55369 Phone: 763-267-2015
Barbara I Benson, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 14500 99th Ave N, Maple Grove, MN 55369 Phone: 763-898-1073
Nicole Doering, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 11157 Meadow View Ln, Maple Grove, MN 55311 Phone: 612-719-0645
Jennifer Bremer, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 14500 99th Ave N, Maple Grove, MN 55369 Phone: 763-898-1000
Joy Nieves Anderson, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 9630 Grove Cir N Ste 200, Maple Grove, MN 55369 Phone: 763-520-7870 Fax: 763-520-7580
Carrie M Reynoso, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 14500 99th Ave N, Maple Grove, MN 55369 Phone: 763-898-1000

Mrs Tracy Mindiola, RD - Medicare Dietitian in Maple Grove, MN