| Dr Heather Anne Decker, MD | |
| 2251 Connecticut Ave S, Sartell, MN 56377 | |
| (320) 253-5220 | |
| (320) 203-2200 | 
| Full Name | Dr Heather Anne Decker | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 2251 Connecticut Ave S, Sartell, Minnesota | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1336114529 | NPI | - | NPPES | 
| 036111062 | Medicaid | IL | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 036111062 (Illinois) | Secondary | 
| 208000000X | Pediatrics | 63914 (Minnesota) | Primary | 
| Entity Name | Park Nicollet Clinic | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 | 
| Entity Name | Group Health Plan Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1710924683 PECOS PAC ID: 1759293954 Enrollment ID: O20031105000417 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Heather Anne Decker, MD 8170 33rd Ave S, Ms 21110q, Bloomington, MN 55425-4516 Ph: (320) 253-5220 | Dr Heather Anne Decker, MD 2251 Connecticut Ave S, Sartell, MN 56377 Ph: (320) 253-5220 | 
| Emily Korman, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 111 2nd St S, Sartell, MN 56377 Phone: 320-281-3339 Fax: 320-200-7505 | |
| David Smith, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 111 2nd St S, Sartell, MN 56377 Phone: 320-281-3339 Fax: 320-251-6942 |