Kalisa Rurinda Ndikubwimana, DNP-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

13025 Issued in MN

Practice address

1725 Legacy Pkwy E Ste 100
Maplewood, MN 55109-5434

Phone

(952) 234-8580

Fax

(952) 841-2346

NPI assigned

Sep 16, 2025

Last updated

Sep 16, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Andrew J Will MD PAGroup PAC ID 9830152495, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Andrew J Will MD PA

  dba Twin Cities Pain Clinic

  • Physical Medicine & Rehabilitation Physician
  • Edina, MN
  • NPI 1215003066
  Medicare reassignment Care Compare group NPD
• Andrew J Will MD PA

  dba Twin Cities Pain Clinic

  • Pain Clinic/Center
  • Chaska, MN
  • NPI 1669167920
  NPD
• Andrew J Will MD PA

  dba Twin Cities Pain Clinic

  • Pain Clinic/Center
  • Woodbury, MN
  • NPI 1699199737
  NPD

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

{
    "created_epoch": "1757980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1427929124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 LEGACY PKWY E STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095434",
            "telephone_number": "952-234-8580",
            "fax_number": "952-841-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 LEGACY PKWY E STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095434",
            "telephone_number": "952-234-8580",
            "fax_number": "952-841-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDIKUBWIMANA",
        "first_name": "KALISA",
        "middle_name": "RURINDA",
        "credential": "DNP-CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-16",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "13025",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "13025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Martin Naslund, PA-C
• Nasra S Gonjobe (Nasra S Gonjobe and Abdi G Gonjobe)
• National Vision, Inc. (America's Best Contacts & Eyeglasses)
• NBH Heather Ridge LLC
• NBH Mental Health Services LLC
• Jettie Mae Ndumbe I, LPN
• Ethan Daniel Nelson
• Jennifer K Nelson, PA
• Lindsay Anne Nelson, APRN, CNM
• Matthew Scott Nelson, NP

• Family Nurse Practitioner in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.