NPIMap

Individual provider Active NPI

Nicole Elizabeth Kowalkowski

  • Family Nurse Practitioner
  • Maple Grove, MN
National Provider Identifier
1639053531
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12823 Issued in MN
Practice address
11297 Kingsview LN N
Maple Grove, MN 55369-7746
Phone
(763) 226-8133
NPI assigned
Aug 4, 2025
Last updated
Mar 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12823 MN Primary

Addresses

Primary practice location

11297 Kingsview LN N
Maple Grove, MN 55369-7746

Mailing address

11297 Kingsview LN N
Maple Grove, MN 55369-7746
Phone (763) 226-8133

Other practice location 1

11850 Blackfoot St NW Ste 300
Coon Rapids, MN 55433-2772
Phone (763) 236-0808

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nkowalkowski753127@excellian.direct.allina.com Direct

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
I20251118003925 MN Practitioner - Nurse Practitioner 8123519063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

1285 Nininger Rd
Hastings, MN 55033-1086
Phone (651) 480-4200

225 Smith Ave N
Suite 200
Saint Paul, MN 55102-2697
Phone (651) 241-5111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Dec 25, 2025 Accepting new patients
Allina Health System CurrentSince Dec 1, 2025 Accepting new patients
Allina Health System CurrentSince Dec 1, 2025 Accepting new patients
NPI 1083910871 Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

1285 Nininger Rd
Hastings, MN 55033
Phone (651) 480-4200

11850 Blackfoot St NW
Ste 300
Minneapolis, MN 55433
Phone (763) 236-0808

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

225 Smith Ave N
Ste 200
Saint Paul, MN 55102
Phone (651) 241-5111

Interoperability endpoints

  • Direct secure messaging: nkowalkowski753127@excellian.direct.allina.com

Organizations & group practices 6

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 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1639053531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11297 KINGSVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697746",
            "telephone_number": "763-226-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11297 KINGSVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697746",
            "telephone_number": "763-226-8133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11850 Blackfoot St NW Ste 300",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332772",
            "country_code": "US",
            "telephone_number": "763-236-0808",
            "fax_number": "763-236-6065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWALKOWSKI",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "12823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkowalkowski753127@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "11850 Blackfoot St NW Ste 300",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554332772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.