Individual provider Active NPI

Tarikua Katiso

  • Family Nurse Practitioner
  • Woodbury, MN
National Provider Identifier
1063206134
Registry record updated Apr 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12379 Issued in MN
Practice address
10792 Ashley LN
Woodbury, MN 55129-6903
Phone
(651) 497-1459
NPI assigned
Apr 5, 2025
Last updated
Apr 5, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12379 MN Primary

Addresses

Primary practice location

10792 Ashley LN
Woodbury, MN 55129-6903

Mailing address

10792 Ashley LN
Woodbury, MN 55129-6903
Phone (651) 497-1459

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
I20250424003729 MN Practitioner - Nurse Practitioner 0547786212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of Minnesota PLLCGroup PAC ID 6305233461, 62 clinicians

Practice addresses (Care Compare)

5123 W 98TH St
Suite 2082
Minneapolis, MN 55437-2040
Phone (737) 226-6700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12379MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of Minnesota PLLC CurrentSince May 6, 2025 Accepting new patients
CH Specialty Services MN PC CurrentSince May 6, 2025 Accepting new patients

Locations

5750 Johnston St
Ste 205
Lafayette, LA 70503
Phone (337) 580-3330

5123 W 98th St
Minneapolis, MN 55437
Phone (312) 961-4490

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 5

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": "1743811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743811200000",
    "number": "1063206134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10792 ASHLEY LN",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551296903",
            "telephone_number": "651-497-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10792 ASHLEY LN",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551296903",
            "telephone_number": "651-497-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATISO",
        "first_name": "TARIKUA",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-04-05",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "12379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.