Individual provider Active NPI

Kaia Elizabeth Lundin Scales, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rochester, MN
National Provider Identifier
1265910889
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
6054 Issued in MN
Practice address
210 9TH St SE
Rochester, MN 55904-6756
Phone
(507) 288-3443
NPI assigned
Aug 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 6054 MN Primary
Family Nurse Practitioner 363LF0000X 6054 MN

Addresses

Primary practice location

210 9TH St SE
Rochester, MN 55904-6756

Mailing address

210 9TH St SE
Rochester, MN 55904-6756
Phone (507) 288-3443

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
I20180830003340 MN Practitioner - Nurse Practitioner 0547510117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Croix Psychiatric LLCGroup PAC ID 9335288786, 45 clinicians

Practice addresses (Care Compare)

12915 63Rd Ave N
Maple Grove, MN 55369-6001
Phone (952) 826-8475

5255 Members Pkwy NW
Rochester, MN 55901-8381
Phone (507) 218-3701

9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone (952) 826-8475

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6054MNMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Psychiatric, LLC CurrentSince Jul 11, 2022 Accepting new patients
Fernbrook Family Center, Inc CurrentSince Oct 23, 2020 Accepting new patients
Fernbrook Family Center Past Accepting new patients

Locations

9400 Zane Ave N
Minneapolis, MN 55443
Phone (763) 383-5800

2575 Harvest Ln
Owatonna, MN 55060
Phone 5074460431115

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1265910889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 9TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046756",
            "telephone_number": "507-288-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 9TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046756",
            "telephone_number": "507-288-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCALES",
        "first_name": "KAIA",
        "middle_name": "ELIZABETH LUNDIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "6054",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6054",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.