Individual provider Active NPI

Andrea Jo Pater, FNP-BC

  • Family Nurse Practitioner
  • Cass Lake, MN
National Provider Identifier
1275814659
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R162986-2 Issued in MN
Practice address
425 7TH St NW
Cass Lake, MN 56633-3360
Phone
(218) 335-3200
NPI assigned
Aug 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X CNP3513 MN
Family Nurse Practitioner 363LF0000X R162986-2 MN Primary

Addresses

Primary practice location

425 7TH St NW
Cass Lake, MN 56633-3360

Mailing address

425 7TH St NW
Cass Lake, MN 56633-3360
Phone (218) 335-3200

Other practice location 1

425 7th St NW
Cass Lake, MN 56633-3360
Phone (218) 335-3200

Other names 1

  • Andrea Jo Athmann-Luksik Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111202000434 MN Practitioner - Nurse Practitioner 0840465886 Reassigns benefits to 2 organizations
I20140203000212 TX Practitioner - Nurse Practitioner 0840465886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

425 7TH St NW
Cass Lake, MN 56633-3360

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.56 of 100Reported as group
Quality
74.25
Promoting interoperability
100
Improvement activities
40
Cost
76.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3513MNMDVision Therapy Optometrist
CNP3513MNMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Health & Human Services PHS IHS CurrentSince Oct 8, 2013 Accepting new patients
Lifecare Medical Center Current Accepting new patients

Locations

350 E Devon Ave
Itasca, IL 60143

425 7th St NW
Cass Lake, MN 56633
Phone (218) 335-3200

Organizations & group practices 2

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.

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": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1275814659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 7TH ST NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "566333360",
            "telephone_number": "218-335-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 7TH ST NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "566333360",
            "telephone_number": "218-335-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 7th St NW",
            "address_purpose": "LOCATION",
            "city": "Cass Lake",
            "state": "MN",
            "postal_code": "566333360",
            "country_code": "US",
            "telephone_number": "218-335-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATER",
        "first_name": "ANDREA",
        "middle_name": "JO",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "CNP3513",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R162986-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "ATHMANN-LUKSIK",
            "middle_name": "JO",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cass Lake, MN

Sources for this page

Verify at the official NPI Registry.