NPIMap

Individual provider Active NPI

Wendy Marie Zitzloff, ACNP AG

  • Critical Care Medicine Nurse Practitioner
  • Coon Rapids, MN
National Provider Identifier
1164092359
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
8547 Issued in MN
Practice address
1350 107TH Ave NW
Coon Rapids, MN 55433-6333
Phone
(320) 423-1081
NPI assigned
Jun 29, 2021
Last updated
Dec 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 8547 MN Primary

Addresses

Primary practice location

1350 107TH Ave NW
Coon Rapids, MN 55433-6333

Mailing address

1350 107TH Ave NW
Coon Rapids, MN 55433-6333
Phone (320) 423-1081

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
I20241218000856 MN Practitioner - Nurse Practitioner 2668909474 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeris Medical Group PLLCGroup PAC ID 0042624306, 26 clinicians

Practice addresses (Care Compare)

St Louis Park, MN 55416
Phone (914) 589-5503

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8547MNMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP CurrentSince Aug 1, 2025 Accepting new patients
Aeris Medical Group PLLC CurrentSince Nov 12, 2024 Accepting new patients

Locations

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097

305 Fremont St
Anoka, MN 55303
Phone (763) 421-5660

515 Division St
Excelsior, MN 55331
Phone (952) 474-5488

800 2nd Ave NW
Plainview, MN 55964
Phone (507) 534-3191

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 10

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1164092359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 107TH AVE NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554336333",
            "telephone_number": "320-423-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 107TH AVE NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554336333",
            "telephone_number": "320-423-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZITZLOFF",
        "first_name": "WENDY",
        "middle_name": "MARIE",
        "credential": "ACNP AG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "MN",
            "license": "8547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.