Individual provider Active NPI

Alexandro Vasquez, D.N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Mankato, MN
National Provider Identifier
1619313103
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3640 Issued in MN
Practice address
1025 Marsh St
Mankato, MN 56001-4752
Phone
(507) 625-4031
NPI assigned
May 11, 2013
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6372 WI
Registered Nurse 163W00000X 688299 CA
Nurse Practitioner 363L00000X 6372 WI
Family Nurse Practitioner 363LF0000X 23675 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3640 MN Primary

Addresses

Primary practice location

1025 Marsh St
Mankato, MN 56001-4752

Mailing address

PO Box 1510
Eau Claire, WI 54702-1510
Phone (715) 838-5222

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (214) 727-2697

Other practice location 2

1222 E Woodland Ave
Barron, WI 54812-1765
Phone (715) 537-3166

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
I20201005001221 MN Practitioner - Nurse Practitioner 9133352115 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Stone Creek Psychiatry LLCGroup PAC ID 2365608726, 3 clinicians

Practice addresses (Care Compare)

100 S 2ND St
Suite B
Eagle Lake, MN 56024-7714
Phone (507) 654-0020

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

7945 Stone Creek Dr
Suite 130
Chanhassen, MN 55317-4698
Phone (952) 241-4050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
688299CAMDRegistered Nurse
23675CAMDCase Manager/Care Coordinator
6372WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
River's Edge Hospital & Clinic CurrentSince Apr 1, 2021 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Oct 1, 2020 Accepting new patients
Mille Lacs Health System CurrentSince Oct 21, 2020 Accepting new patients
Stone Creek Psychiatry, LLC CurrentSince Jul 22, 2024 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Mar 1, 2025 Accepting new patients
Clear Path Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jun 1, 2025 Accepting new patients
Mille Lacs Health System CurrentSince Oct 21, 2020 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Mar 1, 2025 Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

7945 Stone Creek Dr
Ste 130
Chanhassen, MN 55317
Phone (952) 241-4050

100 S 2nd St
Unit B
Eagle Lake, MN 56024
Phone (507) 654-0020

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1900 Sunrise Dr
Saint Peter, MN 56082
Phone (507) 931-2200

1221 Whipple St
Eau Claire, WI 54703
Phone (715) 831-0100

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1368230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1619313103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "214-727-2697",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1222 E Woodland Ave",
            "address_purpose": "LOCATION",
            "city": "Barron",
            "state": "WI",
            "postal_code": "548121765",
            "country_code": "US",
            "telephone_number": "715-537-3166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "ALEXANDRO",
        "name_prefix": "Mr.",
        "credential": "D.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-11",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6372",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "688299",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6372",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23675",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "3640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.