NPIMap

Individual provider Active NPI

Annmarie Elizabeth Anderson, PA-C

  • Physician Assistant
  • Shakopee, MN
National Provider Identifier
1104447531
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1700 Saint Francis Ave
Shakopee, MN 55379-5582
Phone
(952) 831-8742
NPI assigned
Apr 27, 2020
Last updated
Jul 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1700 Saint Francis Ave
Shakopee, MN 55379-5582

Mailing address

1700 Saint Francis Ave
Shakopee, MN 55379-5582
Phone (507) 382-3305

Other practice location 1

110 N 4th St
Saint Peter, MN 56082-1917
Phone (507) 382-3305

Other practice location 2

8 Iowa St Apt 3M
Oak Park, IL 60302-2496
Phone (507) 382-3305

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210824003001 MN Practitioner - Physician Assistant 5294130530 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hutchinson HealthGroup PAC ID 0345330072, 145 clinicians
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

1029 Hwy 15 S
Hutchinson, MN 55350-3153
Phone (320) 484-4400

1071 Hwy 15 S
Hutchinson, MN 55350-3153
Phone (320) 484-4610

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Health CurrentSince Sep 12, 2021 Accepting new patients
Park Nicollet Clinic CurrentSince Jul 1, 2024 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Jan 14, 2024 Accepting new patients
Hutchinson Medical Center PA Past Accepting new patients

Locations

1029 Highway 15 S
Hutchinson, MN 55350
Phone (320) 275-3358

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

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, 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": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1104447531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SAINT FRANCIS AVE",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553795582",
            "telephone_number": "507-382-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SAINT FRANCIS AVE",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553795582",
            "telephone_number": "952-831-8742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Saint Peter",
            "state": "MN",
            "postal_code": "560821917",
            "country_code": "US",
            "telephone_number": "507-382-3305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 Iowa St Apt 3M",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603022496",
            "country_code": "US",
            "telephone_number": "507-382-3305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANNMARIE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.