Individual provider Active NPI

Kristen J Anderson, MPAC

  • Physician Assistant
  • Aurora, NE
National Provider Identifier
1063521094
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
841 Issued in NE
Practice address
609 O St
Aurora, NE 68818-1100
Phone
(402) 694-3191
Fax
(402) 694-2146
NPI assigned
Aug 30, 2006
Last updated
Sep 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 841 NE Primary

Addresses

Primary practice location

609 O St
Aurora, NE 68818-1100

Mailing address

609 O St
Aurora, NE 68818-1100
Phone (402) 694-3191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20100914001042 NE Practitioner - Physician Assistant 1557486545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

715 N Saint Joseph Ave
Mary Lanning Healthcare
Hastings, NE 68901-4451
Phone (402) 463-4521

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Mary Lanning Memorial Hospital Association CurrentSince Jun 1, 2018 Accepting new patients
The Mary Lanning Memorial Hospital Association CurrentSince Jun 1, 2018 Accepting new patients
Hastings Family Practice, P.C Past Accepting new patients

Locations

2620 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-6856

715 N Saint Joseph Ave
Hastings, NE 68901
Phone (402) 461-5036

Organizations & group practices 3

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 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1063521094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 O ST",
            "city": "AURORA",
            "state": "NE",
            "postal_code": "688181100",
            "telephone_number": "402-694-3191",
            "fax_number": "402-694-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 O ST",
            "city": "AURORA",
            "state": "NE",
            "postal_code": "688181100",
            "telephone_number": "402-694-3191",
            "fax_number": "402-694-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KRISTEN",
        "middle_name": "J",
        "credential": "MPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, NE

Sources for this page

Verify at the official NPI Registry.