Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Richard John Mastenbrook, CNP

Individual provider Nurse Practitioner · NPI 1619386083

Mr. Richard John Mastenbrook, CNP is a Nurse Practitioner in Chisago City, Minnesota. Qualified in 2014, 12 years ago. Practices with Fairview Clinics, a 806-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
12
Licensed in
MN
In the registry since
2014
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

11725 Stinson Ave
Chisago City, MN 55013-9542
Phone: (651) 257-8850
Fax: (651) 257-8852
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence AG0714121 (MN)

Record details

NPI number1619386083
Entity typeIndividual (Type 1)
GenderMale
Credentials CNP
Sole proprietorYes
NPI enumeratedAugust 10, 2014
Last updated in NPPESAugust 11, 2022
Certification dateAugust 11, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Fairview Clinics — 806 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare