Individual provider Active NPI

Kristan Lam

  • Audiologist
  • Minneapolis, MN
National Provider Identifier
1386028181
Registry record updated Mar 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
9650 Issued in MN
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(612) 813-6000
NPI assigned
Jul 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 078062 IA
Audiologist 231H00000X 078000 IA
Audiologist 231H00000X 9650 MN Primary

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

17590 Hemlock Ave
Lakeville, MN 55044-3904

Other names 1

  • Kristan Sershen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170119001119 MN Practitioner - Qualified Audiologist 4789998618 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078062IAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute Current Accepting new patients
Childrens Health Care CurrentSince May 5, 2025 Accepting new patients
Childrens Health Care CurrentSince May 5, 2025 Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Clinics CurrentSince Nov 26, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Childrens Health Care Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Dec 13, 2016 Accepting new patients
Fairview Clinics CurrentSince Nov 26, 2020 Accepting new patients
Fairview Health Services CurrentSince Jul 30, 2019 Accepting new patients

Locations

13819 Hanson Blvd NW
Andover, MN 55304
Phone (763) 572-5700

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

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

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

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

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

1390 University Ave W
Saint Paul, MN 55104
Phone (651) 232-4800

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741392000000",
    "number": "1386028181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17590 HEMLOCK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "KRISTAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IA",
            "license": "078062",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IA",
            "license": "078000",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "9650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTAN",
            "last_name": "SERSHEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.