Individual provider Active NPI

Kirstin Moneaka Baker, APRN, CNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Golden Valley, MN
National Provider Identifier
1205523347
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10115 Issued in MN
Practice address
1030 Orkla Dr
Golden Valley, MN 55427-4440
Phone
(612) 443-7424
NPI assigned
Apr 19, 2023
Last updated
Sep 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10115 MN Primary

Addresses

Primary practice location

1030 Orkla Dr
Golden Valley, MN 55427-4440

Mailing address

1030 Orkla Dr
Golden Valley, MN 55427-4440
Phone (612) 443-7424

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
I20230509002201 MN Practitioner - Nurse Practitioner 1759747157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

1345 Mendota Heights Rd
Suite 600
Mendota Heights, MN 55120-2006
Phone (651) 313-8080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10115MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Apr 13, 2026 Accepting new patients

Locations

1345 Mendota Heights Rd
Ste 600
Mendota Heights, MN 55120

1370 Mendota Heights Rd
Mendota Heights, MN 55120
Phone (651) 764-7245

1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 307-5148

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1205523347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 ORKLA DR",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274440",
            "telephone_number": "612-443-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 ORKLA DR",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274440",
            "telephone_number": "612-443-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "KIRSTIN",
        "middle_name": "MONEAKA",
        "credential": "APRN, CNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "10115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.