| Richfield Medical Group Ltd | |
|
6440 Nicollet Ave So Richfield MN 55423 | |
| (612) 861-1622 | |
| (612) 861-2307 |
| Full Name | Richfield Medical Group Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 6440 Nicollet Ave So, Richfield, Minnesota |
| Authorized Official Name and Position | Nate Moretter-bue (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 1267674736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richfield Medical Group Ltd 6440 Nicollet Ave So Richfield MN 55423 Ph: (612) 861-1622 | Richfield Medical Group Ltd 6440 Nicollet Ave So Richfield MN 55423 Ph: (612) 861-1622 |
| NPI Number | 1235297342 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 01/18/2024 |
| Medicare PECOS PAC ID | 9032154497 |
|---|---|
| Medicare Enrollment ID | O20050627000159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235297342 | NPI | - | NPPES |
| 929208900 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kevin C Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891765202 PECOS PAC ID: 9830171875 Enrollment ID: I20100119000771 |
| Provider Name | Justin D Golden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659698512 PECOS PAC ID: 7719158955 Enrollment ID: I20110920000930 |
| Provider Name | Alice Macdonald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457771271 PECOS PAC ID: 8527352095 Enrollment ID: I20160805000592 |
| Provider Name | Lisa Renee Braatz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548922883 PECOS PAC ID: 9335539550 Enrollment ID: I20211202001497 |
| Provider Name | Megan Dutton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598428872 PECOS PAC ID: 0244622090 Enrollment ID: I20220128000121 |
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