Kassandra Elizabeth Anderson, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Tyler, MN
NPI 1619626652 · NPPES record last updated Mar 18, 2022
Key facts
- NPI
- 1619626652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 9047 (MN)
- Practice address
- 240 Willow St
Tyler, MN 56178-1201 - Phone
- (507) 247-5521
- NPI assigned
- Mar 18, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Avera Tyler
Practice addresses (Care Compare)
240 Willow St
Tyler, MN 56178-1201
Phone (507) 247-5521
Hospital & facility affiliations
- Avera Tyler Hospital
- Avera Marshall Regional Medical Ctr
- Avera Granite Falls
- Pipestone County Medical Center
- Murray County Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in 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 |
|---|---|---|---|---|
| I20220714002443 | MN | Practitioner - Nurse Practitioner | 7214318708 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9047 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera Granite Falls | Current |
Accepting new patients | |
| Avera Tyler | Current | Accepting new patients | |
| Avera Tyler | Family | Current |
Accepting new patients |
| Avera Tyler | Current |
Accepting new patients | |
| Granite Falls Municipal Hospital and Manor | Past | Accepting new patients | |
| Avera Tyler | Past | Accepting new patients |
Locations
345 10th Ave
Granite Falls, MN 56241
Phone (320) 564-3111
300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9047 | MN | Yes |
Addresses
Primary practice location
240 Willow St
Tyler, MN 56178-1201
Mailing address
203 Maye St
Tyler, MN 56178-9490
Phone (605) 838-7118
Other providers in Tyler, MN
All providers in Tyler, MN · Family 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 Mar 18, 2022. 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.