NPIMap

Individual provider Active NPI

Kaila Rae Sullivan, DO

  • Family Medicine Physician
  • Saint Peter, MN
National Provider Identifier
1629659743
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
72407 Issued in MN
Practice address
1900 Sunrise Dr
Saint Peter, MN 56082-5376
Phone
(507) 665-6299
NPI assigned
Apr 20, 2021
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 72407 MN Primary

Addresses

Primary practice location

1900 Sunrise Dr
Saint Peter, MN 56082-5376

Mailing address

200 1St St SW
Rochester, MN 55905-6460
Phone (507) 284-2511

Other practice location 1

101 Martin Luther King Jr. Dr
Mankato, MN 56001-6460
Phone (507) 594-6572

Other names 1

  • Kaila Rae Anderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240830001078 MN Practitioner - Family Practice 7214336866 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

1900 Sunrise Dr
Saint Peter, MN 56082-5376
Phone (507) 931-2200

7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
72407MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Valley Health Center Inc CurrentSince Dec 29, 2025 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Aug 15, 2024 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Aug 15, 2024 Accepting new patients
Ridgeview Medical Center CurrentSince Dec 29, 2025 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Minnesota Valley Health Center Inc CurrentSince Dec 29, 2025 Accepting new patients
Sibley Medical Center CurrentSince Dec 29, 2025 Accepting new patients
Ridgeview Medical Center Family Medicine CurrentSince Dec 29, 2025 Accepting new patients

Locations

601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

621 S 4th St
Le Sueur, MN 56058
Phone (507) 665-3375

101 Martin Luther King Dr
Mankato, MN 56001
Phone (507) 385-6500

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

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

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

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Interoperability endpoints

  • Direct secure messaging: kanderson974030@ehrdirect.mayoclinicmsg.org

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 5

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": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1629659743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559056460",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SUNRISE DR",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560825376",
            "telephone_number": "507-665-6299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Martin Luther King Jr. Dr",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "560016460",
            "country_code": "US",
            "telephone_number": "507-594-6572",
            "fax_number": "507-594-6959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KAILA",
        "middle_name": "RAE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "72407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAILA",
            "last_name": "ANDERSON",
            "middle_name": "RAE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Peter, MN

Sources for this page

Verify at the official NPI Registry.