NPIMap

Individual provider Active NPI

Susan Lea Andersen, CNP

  • Nurse Practitioner
  • Albert Lea, MN
National Provider Identifier
1689188351
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5434 Issued in MN
Practice address
404 W Fountain St
Albert Lea, MN 56007-2437
Phone
(888) 999-2386
NPI assigned
Nov 16, 2017
Last updated
Mar 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5434 MN
Nurse Practitioner 363L00000X 5434 MN Primary

Addresses

Primary practice location

404 W Fountain St
Albert Lea, MN 56007-2437

Mailing address

PO Box 860912
Minneapolis, MN 55486-0912
Phone (507) 373-2384

Other practice location 1

2708 Bridge Ave
Albert Lea, MN 56007-2077
Phone (507) 668-2244

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbodeker67902@ehrdirect.mayoclinicmsg.org

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
I20180123001995 MN Practitioner - Nurse Practitioner 0345509253 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, shared by 6 NPIs, 658 clinicians

Practice addresses (Care Compare)

101 Martin Luther King Dr
Jr
Mankato, MN 56001-6460
Phone (507) 385-6500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5434MNMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
LCM Pathologists PC Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Feb 1, 2018 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Aug 1, 2019 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jan 1, 2022 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Feb 1, 2018 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Fairmont Past Accepting new patients

Locations

2708 Bridge Ave
Albert Lea, MN 56007
Phone (507) 373-1899

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

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

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

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

301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431

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": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1689188351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860912",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860912",
            "telephone_number": "507-373-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W FOUNTAIN ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072437",
            "telephone_number": "888-999-2386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2708 Bridge Ave",
            "address_purpose": "LOCATION",
            "city": "Albert Lea",
            "state": "MN",
            "postal_code": "560072077",
            "country_code": "US",
            "telephone_number": "507-668-2244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "SUSAN",
        "middle_name": "LEA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "5434",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "5434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbodeker67902@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "404 W Fountain St",
            "city": "Albert Lea",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560072437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albert Lea, MN

Sources for this page

Verify at the official NPI Registry.