Individual provider Active NPI

Anita Thampy, M.D

  • Psychiatry Physician
  • Maple Grove, MN
National Provider Identifier
1023205465
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
50727 Issued in MN
Practice address
13603 80TH Cir N
Maple Grove, MN 55369-8961
Phone
(763) 274-3120
Fax
(763) 274-3121
NPI assigned
Oct 1, 2007
Last updated
Apr 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 50727 MN Primary

Addresses

Primary practice location

13603 80TH Cir N
Maple Grove, MN 55369-8961

Mailing address

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786
Phone (651) 628-9566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090820000335 MN Practitioner - Psychiatry 8022162353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

13603 80TH N Cir
Maple Grove, MN 55369-8961
Phone (763) 416-1489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50727MNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince May 1, 2017 Accepting new patients
Family Support Services Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

13603 80th Cir N
Maple Grove, MN 55369
Phone (763) 274-3120

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1023205465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13603 80TH CIR N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553698961",
            "telephone_number": "763-274-3120",
            "fax_number": "763-274-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAMPY",
        "first_name": "ANITA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "50727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.