Individual provider Active NPI

Kathryn Joan Tietz, NP

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1043095656
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10622 Issued in MN
Practice address
800 E 28TH St Ste H2100
Minneapolis, MN 55407-3723
Phone
(612) 863-3900
Fax
(612) 775-3199
NPI assigned
Aug 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10622 MN
Family Nurse Practitioner 363LF0000X 10622 MN Primary

Addresses

Primary practice location

800 E 28TH St Ste H2100
Minneapolis, MN 55407-3723

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Other practice location 1

920 E 28th St Ste 300
Minneapolis, MN 55407-1195
Phone (612) 863-3963

Other names 1

  • Kathryn Joan Traynor Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ktraynor364852@excellian.direct.allina.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231024000961 MN Practitioner - Nurse Practitioner 4284080532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

1601 Saint Francis Ave
Suite 100
Shakopee, MN 55379-3384
Phone (952) 428-3535

800 E 28TH St
Suite H2100
Minneapolis, MN 55407-3723
Phone (612) 863-3900

Hospital & facility affiliations

  • St Francis Regional Medical Center Hospital, Shakopee, MN, CCN 240104

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10622MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince May 5, 2025 Accepting new patients
Allina Health System CurrentSince Nov 27, 2023 Accepting new patients
Allina Health System CurrentSince Nov 27, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

800 E 28th St
Ste H2100
Minneapolis, MN 55407
Phone (612) 863-3900

920 E 28th St
Ste 300
Minneapolis, MN 55407
Phone (612) 863-3900

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

1601 Saint Francis Ave
Ste 100
Shakopee, MN 55379
Phone (952) 403-3535

Interoperability endpoints

  • Direct secure messaging: ktraynor364852@excellian.direct.allina.com

Organizations & group practices 6

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1043095656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST STE H2100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-3900",
            "fax_number": "612-775-3199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 E 28th St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554071195",
            "country_code": "US",
            "telephone_number": "612-863-3963",
            "fax_number": "612-863-1681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIETZ",
        "first_name": "KATHRYN",
        "middle_name": "JOAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "10622",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "10622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktraynor364852@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "800 E 28th St Ste H2100",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554073723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "TRAYNOR",
            "middle_name": "JOAN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.