Amanda Mae Hartzell Middendorf, APNP
Individual provider Active NPI Gerontology Nurse Practitioner · Caledonia, MN
NPI 1558027052 · NPPES record last updated Feb 2, 2026
Key facts
- NPI
- 1558027052
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 11435 (WI)
- Practice address
- 405 S Highway 44 76
Caledonia, MN 55921-1861 - Phone
- (608) 668-9118
- Fax
- (608) 305-8746
- NPI assigned
- Nov 10, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1010 E Wausau Ave
Wausau, WI 54403-3101
Phone (715) 842-2028
405 S Hwy 44 76
Caledonia, MN 55921-1861
Phone (608) 668-9118
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI, MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211203000738 | WI | Practitioner - Nurse Practitioner | 0749670818 | Reassigns benefits to 3 organizations |
| I20241023000895 | MN | Practitioner - Nurse Practitioner | 0749670818 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11435 | WI | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gundersen Lutheran Medical Center Inc | Current |
Accepting new patients | |
| Gundersen Lutheran Medical Center, Inc | Current |
Accepting new patients | |
| Infinite Medical PC | Current |
Accepting new patients | |
| Traveling Health LLC | Gerontology | Current |
Accepting new patients |
| Gundersen Lutheran Medical Center Inc | Current | Accepting new patients | |
| Metro Infectious Disease Consultants, LLC | Past | Accepting new patients |
Locations
405 S Highway 44 76
Caledonia, MN 55921
Phone (608) 668-9118
3245 Vera Cruz Ave N
Robbinsdale, MN 55422
Phone (516) 729-0070
250 Skillman St
Ste 202
Brooklyn, NY 11205
430 Wilcox St
Fort Atkinson, WI 53538
Phone (920) 563-5533
1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287
1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102
1010 E Wausau Ave
Wausau, WI 54403
Phone (715) 623-2028
Interoperability endpoints
- amiddendorf541229@direct.gundersenhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 11435 | WI | |
| Gerontology Nurse Practitioner | 363LG0600X | 11435 | WI | Yes |
Addresses
Primary practice location
405 S Highway 44 76
Caledonia, MN 55921-1861
Mailing address
405 S Highway 44 76
Caledonia, MN 55921-1861
Phone (608) 668-9118
Other names
- Amanda Mae Middendorf
Other providers in Caledonia, MN
- Family Dental Center of Caledonia LLC
- James John Fink
- Gundersen Clinic LTD
- Keli Gwost
- Abraham Joseph Hammell
- Herman Dental Clinic PA
- Sarah Ruth Herman
- Hiawatha Valley Mental Health Center
- Houston County Auditor
- Houston County Human Services
All providers in Caledonia, MN · Gerontology Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.