PARK NICOLLET HEALTH CARE PRODUCTS
NPI 1487105995
Durable Medical Equipment & Medical Supplies in Shakopee, MN

Q: What is Park Nicollet Health Care Products's NPI number?

The NPI number for Park Nicollet Health Care Products is 1487105995. It was assigned to this organization in the NPPES registry on October 19, 2016.

Q: What is Park Nicollet Health Care Products's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Active since October 19, 2016

1455 SAINT FRANCIS AVE, SHAKOPEE, MN 55379(952) 993-7644(952) 993-0562 Get Directions Write a Review

NPPES record last updated: November 7, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 7, 2024, Oct 19, 2016 (2 updates tracked since 2016).

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About Park Nicollet Health Care Products NPPES

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

PARK NICOLLET HEALTH CARE PRODUCTS (NPI 1487105995) is a healthcare organization registered as a durable medical equipment & medical supplies in Shakopee, Minnesota and active in the NPI registry since October 2016. The organization lists Kristin D Brey, Supervisor/delegated Official, as its authorized official.

NPPES Registry Identity

NPI1487105995

Entity TypeOrganization

Primary Taxonomy332B00000X

Legal Business NamePARK NICOLLET HEALTH CARE PRODUCTS

Location Address1455 SAINT FRANCIS AVEShakopee, MN 55379-3374

Mailing Address3800 Park Nicollet Blvd # Ms 61901cSt Louis Park, MN 55416-2527 · Fax (952) 993-0562

Phone(952) 993-7644

Fax(952) 993-0562

Organization SubpartYesParent: Park Nicollet

Authorized OfficialKristin D BreySupervisor/delegated Official · (952) 993-6832

Enumeration DateOctober 19, 2016

Last NPPES UpdateNovember 7, 20242 updates tracked since enumeration

NPPES CertifiedNovember 7, 2024

✔ NPI 1487105995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers

Taxonomy Code332B00000X

Definition

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

1455 SAINT FRANCIS AVE, Shakopee, MN 55379

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Park Nicollet Health Care Products is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateMinnesotaEnrollment IDO20180924000936DME · Medical Supply CompanyDue dateOctober 31, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

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.

DR. JACOB VICTOR SANDER OD, MS

Optometrist