Individual provider Active NPI

Alicia Marie Anderson

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1245875111
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7068 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-4887
NPI assigned
Nov 14, 2019
Last updated
May 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7068 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

7674 Upper 171St St W
Lakeville, MN 55044-7418
Phone (507) 995-4827

Other practice location 1

800 Medical Center Dr
Fairmont, MN 56031-4575
Phone (507) 238-8100

Other identifiers 1

IdentifierTypeStateIssuer
7068OtherMNMN BOARD OF NURSING

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aanderson1108770@ehrdirect.mayoclinicmsg.org

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
I20200110000316 MN Practitioner - Nurse Practitioner 8325473838 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7068MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Group Health, Inc. Family Medicine CurrentSince Mar 6, 2023 Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Jan 1, 2020 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Oct 15, 2022 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jan 1, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 15, 2022 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jan 1, 2020 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Jan 24, 2022 Accepting new patients
Fairview Health Services CurrentSince Jan 1, 2022 Accepting new patients
Group Health, Inc. Current Accepting new patients
Fairview Health Services CurrentSince Jan 1, 2022 Accepting new patients
Fairview Express Care CurrentSince Jan 24, 2022 Accepting new patients
Group Health, Inc. CurrentSince Mar 6, 2023 Accepting new patients
Group Health, Inc. Past Accepting new patients
Group Health, Inc. Past Accepting new patients

Locations

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

640 Jackson St
#11102M
Saint Paul, MN 55101
Phone (651) 254-4887

Interoperability endpoints

  • Direct secure messaging: aanderson1108770@ehrdirect.mayoclinicmsg.org

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 8

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": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1245875111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7674 UPPER 171ST ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447418",
            "telephone_number": "507-995-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-4887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Fairmont",
            "state": "MN",
            "postal_code": "560314575",
            "country_code": "US",
            "telephone_number": "507-238-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ALICIA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BOARD OF NURSING",
            "identifier": "7068",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aanderson1108770@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "800 Medical Center Dr",
            "city": "Fairmont",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560314575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.