Individual provider Active NPI

Alyssa Kong, DNP, APRN, FNP-C

  • Nurse Practitioner
  • Apple Valley, MN
National Provider Identifier
1043800071
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8370 Issued in MN
Practice address
15350 English Ave
Apple Valley, MN 55124-6252
Phone
(952) 431-8500
NPI assigned
Jan 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8370 MN
Nurse Practitioner 363L00000X 8370 MN Primary
Registered Nurse 163W00000X 2283870 MN

Addresses

Primary practice location

15350 English Ave
Apple Valley, MN 55124-6252

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516

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
I20211013002074 MN Practitioner - Nurse Practitioner 2769880202 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

15350 English Ave
Apple Valley, MN 55124-6252
Phone (952) 431-8500

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2283870MNMDRegistered Nurse
8370MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy & Asthma Specialists, PA CurrentSince Oct 1, 2021 Accepting new patients
Group Health, Inc. CurrentSince Jul 22, 2024 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health Plan, Inc. CurrentSince Jul 22, 2024 Accepting new patients

Locations

15350 English Ave
Apple Valley, MN 55124
Phone (952) 431-8500

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

825 Nicollet Mall
Ste 1149
Minneapolis, MN 55402
Phone (612) 338-3333

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1611360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1043800071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15350 ENGLISH AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246252",
            "telephone_number": "952-431-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "ALYSSA",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-23",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8370",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "8370",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2283870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.