NATHAN OSTLIE MD
NPI 1114667367
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Q: What is Nathan Ostlie's NPI number?

The NPI number for Nathan Ostlie is 1114667367. It was assigned to this individual provider in the NPPES registry on March 29, 2022.

Q: What is Nathan Ostlie's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Nathan Ostlie was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 29, 2022PECOS Enrolled

2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 626-2916 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 1, 2025, Jun 28, 2024 (2 updates tracked since 2024).

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About Nathan Ostlie Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NATHAN OSTLIE MD (NPI 1114667367) is an individual student in an organized health care education/training program in Minneapolis, Minnesota, licensed in Minnesota (79667) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114667367

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameNATHAN OSTLIECredential: MD

Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450

Mailing Address2450 Riverside Ave, Rpb550 - 8961bMinneapolis, MN 55454

Phone(612) 626-2916

Sole ProprietorNo

Enumeration DateMarch 29, 2022

Last NPPES UpdateJuly 1, 20252 updates tracked since enumeration

NPPES CertifiedJune 11, 2025

✔ NPI 1114667367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in MN · 79667

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2450 RIVERSIDE AVE, Minneapolis, MN 55454

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nathan Ostlie Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE IRENE GRAY

Rehabilitation Practitioner