Individual provider Active NPI

Amanda Tjaden, MSN

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1447704283
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP5136 Issued in MN
Practice address
401 Harding St NE # 100
Minneapolis, MN 55413-2801
Phone
(888) 709-9344
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016025674 MO
Family Nurse Practitioner 363LF0000X CNP5136 MN Primary

Addresses

Primary practice location

401 Harding St NE # 100
Minneapolis, MN 55413-2801

Mailing address

401 Harding St NE # 100
Minneapolis, MN 55413-2801
Phone (888) 709-9344

Other practice location 1

315 W 75th St
Kansas City, MO 64114-5738
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200824000044 PA Practitioner - Nurse Practitioner 8426344045 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5136MNMDPhysical Therapist
CNP5136MNMDFamily Nurse Practitioner
2016025674MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Current Accepting new patients
Drexel University Current Accepting new patients
Drexel University CurrentSince Jul 17, 2023 Accepting new patients
Drexel University CurrentSince Jul 17, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 12, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 12, 2020 Accepting new patients
Drexel University Past Accepting new patients
Drexel University Past Accepting new patients

Locations

3737 Market St
#9
Philadelphia, PA 19104
Phone (215) 294-9525

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

3401 Market St
Ste 105B
Philadelphia, PA 19104
Phone (215) 220-4700

Organizations & group practices 8

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": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447704283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HARDING ST NE # 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132801",
            "telephone_number": "888-709-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HARDING ST NE # 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132801",
            "telephone_number": "888-709-9344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W 75th St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641145738",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TJADEN",
        "first_name": "AMANDA",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016025674",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP5136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.