Individual provider Active NPI

Anita Jean Lendt Riederer, PAC

  • Physician Assistant
  • New Ulm, MN
National Provider Identifier
1366434532
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9396 Issued in MN
Practice address
1217 8TH St N
New Ulm, MN 56073-1552
Phone
(507) 233-1000
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9396 MN Primary

Addresses

Primary practice location

1217 8TH St N
New Ulm, MN 56073-1552

Mailing address

1217 8TH St N
New Ulm, MN 56073-1552
Phone (507) 233-1000

Other identifiers 1

IdentifierTypeStateIssuer
590027100MedicaidMN

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
I20091204000027 MN Practitioner - Physician Assistant 9436298403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

1324 5TH St N
New Ulm, MN 56073-1514
Phone (507) 217-5199

211 E 2ND St
Winthrop, MN 55396-2390
Phone (507) 647-8000

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

PO Box
Minneapolis, MN 55440-0043

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9396MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jul 26, 2012 Accepting new patients
Allina Health System CurrentSince Jul 26, 2012 Accepting new patients
Allina Health System Past Accepting new patients
Sibley Medical Center Past Accepting new patients

Locations

14000 Nicollet Ave
Ste 100
Burnsville, MN 55337
Phone (950) 985-8275

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

1217 8th St N
New Ulm, MN 56073
Phone (507) 217-5000

Interoperability endpoints

  • Direct secure messaging: ariederer101569@excellian.direct.allina.com

Organizations & group practices 5

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1366434532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 8TH ST N",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "560731552",
            "telephone_number": "507-233-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 8TH ST N",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "560731552",
            "telephone_number": "507-233-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEDERER",
        "first_name": "ANITA",
        "middle_name": "JEAN LENDT",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590027100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Ulm, MN

Sources for this page

Verify at the official NPI Registry.