MAHILET SISAY CNP
NPI 1609205707
Nurse Practitioner - Gerontology in St Louis Park, MN

Q: What is Mahilet Sisay's NPI number?

The NPI number for Mahilet Sisay is 1609205707. It was assigned to this individual provider in the NPPES registry on November 8, 2013.

Q: What is Mahilet Sisay's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Mahilet Sisay was last updated on February 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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 November 08, 2013PECOS EnrolledAccepts Medicare Assignment

5320 W 23RD ST STE 130, ST LOUIS PARK, MN 55416(952) 345-3213 Get Directions Write a Review

NPPES record last updated: February 8, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Mahilet Sisay Cnp NPPES

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

MAHILET SISAY CNP (NPI 1609205707) is an individual gerontology provider in St Louis Park, Minnesota, licensed in Minnesota (10934) and active in the NPI registry since November 2013. She is enrolled in Medicare PECOS, is affiliated with Abbott Northwestern Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1609205707

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameMAHILET SISAYCredential: CNP

Location Address5320 W 23RD ST STE 130St Louis Park, MN 55416-1670

Mailing Address1375 Davern St Apt 408Saint Paul, MN 55116-2290 · (651) 925-9735

Phone(952) 345-3213

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateNovember 8, 2013

Last NPPES UpdateFebruary 8, 2024

NPPES CertifiedFebruary 8, 2024

✔ NPI 1609205707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in MN · 10934

Also ListedRegistered Nurse · Addiction (Substance Use Disorder)Taxonomy 163WA0400X · License R 203829-0 (MN)

5320 W 23RD ST STE 130, St Louis Park, MN 55416

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mahilet Sisay Cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1355785809

PECOS Enrollment IDI20240223000051

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.

Medicare Billing Reassignments

Medicare enrollment records show Mahilet Sisay reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lifespark Medical Group, PA

Same address

Geriatric Medicine

5320 W 23RD ST STE 130
St Louis Park, MN 55416

Reassigned Medicare billing, Minnesota enrollment
60 clinicians in this Medicare group

NPI 1427551746 (952) 345-8770

Spark Medical Providers PA

Same address

Geriatric Medicine

5320 W 23RD ST STE 130
St Louis Park, MN 55416

Reassigned Medicare billing, Minnesota enrollment
21 clinicians in this Medicare group

NPI 1760374680 (952) 345-8770

Curana Health Of Minnesota PLLC

9.3 mi

Internal Medicine

5123 W 98TH ST STE 2082
Minneapolis, MN 55437

Reassigned Medicare billing, Minnesota enrollment
93 clinicians in this Medicare group

NPI 1083365084 (337) 408-0797

Ch Specialty Services Mn PC

9.4 mi

Internal Medicine

5123 W 98TH ST STE 2082
Minneapolis, MN 55437

Reassigned Medicare billing, Minnesota enrollment
90 clinicians in this Medicare group

NPI 1841999158 (337) 408-0797

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

59 services35 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

56 services35 patients

Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes 99344

A new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.

26 services26 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

17 services17 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Abbott Northwestern Hospital

Acute Care Hospitals · Minneapolis, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240057

Location800 East 28th StreetMinneapolis, MN 55407 · Hennepin County

Emergency services Birthing friendly

M Health Fairview Southdale Hospital

Acute Care Hospitals · Edina, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240078

Location6401 France Avenue SouthEdina, MN 55435 · Hennepin County

Emergency services Birthing friendly

M Health Fairview University Of Mn

Acute Care Hospitals · Minneapolis, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240080

Location2450 Riverside AvenueMinneapolis, MN 55454 · Hennepin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55416 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

AKHSA SIMONOVICH FNP

Nurse Practitioner (Family)