Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1992634885 Individual Practitioner Female Practitioner

Madeline Nicole Detra

General Practice • Anoka, MN

Professional Overview & Biography Verified Profile Summary

Madeline Detra is a registered healthcare professional specializing in General Practice in Anoka, MN. Practice services are available at 2621 GREENHAVEN RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2621 Greenhaven Rd

Anoka, MN 553035566

Telephone 7634215540
Associated Practice Facility / Clinic
🏢 Group Health, Inc. Facility NPI 1689068462

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Anoka, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.4 Yrs
Regional Practice Density
1 Specialists

Practicing in Anoka, MN (95 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-05-16
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License MN 1346244274

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

18 Associated Practitioners
NPI 1154634574

Doctor of Pharmacy (Pharm.D.)

Emily Hulke

Pharmacist

NPI 1174185714
NPI 1275537102

Registered Pharmacist

NPI 1356620348

Doctor of Pharmacy (Pharm.D.)

NPI 1407826175

Doctor of Pharmacy (Pharm.D.)

NPI 1427571066

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active May 16, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location May 16, 2026

Registered at 2621 GREENHAVEN RD, ANOKA, MN 553035566 (Tel: 7634215540)

📍
Updated Business Mailing Address May 16, 2026

Registered at 2621 GREENHAVEN RD, ANOKA, MN 553035566 (Tel: 7634215540)

👤
Provider Name / Credentials Updated May 16, 2026

Recorded as MADELINE DETRA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 16, 2026

General Practice (License #1346244274 in MN)

🟢
Initial NPI Registration & Enumeration May 16, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992634885
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 16, 2026
Last Update: May 16, 2026
Sole Proprietor: No

Mailing Address

2621 Greenhaven Rd

Anoka, MN 553035566

Phone: 7634215540

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.