Individual provider Active NPI

Casandera Kay Wiek, FNP

  • Nurse Practitioner
  • Oakdale, MN
National Provider Identifier
1215438189
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP5691 Issued in MN
Practice address
7180 10TH St N
Oakdale, MN 55128-1122
Phone
(651) 242-5890
Fax
(651) 731-6207
NPI assigned
Feb 26, 2018
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP5691 MN Primary

Addresses

Primary practice location

7180 10TH St N
Oakdale, MN 55128-1122

Mailing address

2025 Sloan PL Ste 35
Saint Paul, MN 55117-2092
Phone (651) 772-1572

Other practice location 1

7280 E Point Douglas Rd S
Cottage Grove, MN 55016-3016
Phone (651) 202-2160

Other names 1

  • Casandera Kay Drake Former name

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
I20180328001371 MN Practitioner - Nurse Practitioner 7012279292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2601 Centennial Dr
Suite 100
North St Paul, MN 55109-3087
Phone (651) 788-4444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP5691MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthservices Minnesota, P.a. CurrentSince May 1, 2018 Accepting new patients
Family Healthservices Minnesota, P.a. Past Accepting new patients
East Metro Family Practice, P.a. Past Accepting new patients

Locations

7280 E Point Douglas Rd S
Cottage Grove, MN 55016
Phone (651) 202-2160

7180 10th St N
Oakdale, MN 55128
Phone (651) 242-5890

2025 Sloan Pl
Ste 35
Saint Paul, MN 55117
Phone (651) 772-1572

2601 Centennial Dr
Ste 100
Saint Paul, MN 55109
Phone (651) 777-7414

Interoperability endpoints

  • Direct secure messaging: casandera.wiek@entira.eclinicaldirectplus.com

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 4

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": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1215438189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL STE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172092",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7180 10TH ST N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551281122",
            "telephone_number": "651-242-5890",
            "fax_number": "651-731-6207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7280 E Point Douglas Rd S",
            "address_purpose": "LOCATION",
            "city": "Cottage Grove",
            "state": "MN",
            "postal_code": "550163016",
            "country_code": "US",
            "telephone_number": "651-202-2160",
            "fax_number": "651-458-6918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIEK",
        "first_name": "CASANDERA",
        "middle_name": "KAY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "CNP5691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASANDERA",
            "last_name": "DRAKE",
            "middle_name": "KAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oakdale, MN

Sources for this page

Verify at the official NPI Registry.