NPIMap

Individual provider Active NPI

Tasha L Nelson

  • Physician Assistant
  • Litchfield, MN
National Provider Identifier
1790244457
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12954 Issued in MN
Practice address
520 S Sibley Ave
Litchfield, MN 55355-3030
Phone
(320) 693-3233
Fax
(320) 693-3290
NPI assigned
Mar 13, 2019
Last updated
Mar 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12954 MN Primary

Addresses

Primary practice location

520 S Sibley Ave
Litchfield, MN 55355-3030

Mailing address

520 S Sibley Ave
Litchfield, MN 55355-3030
Phone (320) 693-3233

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
I20190411000675 MN Practitioner - Physician Assistant 9830430263 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of MeekerGroup PAC ID 0840109740, shared by 4 NPIs, 44 clinicians

Practice addresses (Care Compare)

612 S Sibley Ave
Litchfield, MN 55355-3340
Phone (320) 693-3233

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12954MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
County of Meeker CurrentSince Jan 27, 2024 Accepting new patients
County of Meeker Current Accepting new patients
County of Meeker Past Accepting new patients

Locations

740 Parker Ave W
Dassel, MN 55325
Phone (320) 275-4330

520 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-3233

611 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-2804

612 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-3242

Interoperability endpoints

  • Direct secure messaging: tnelson440141@direct.centracare.com

Organizations & group practices 3

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 12

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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1790244457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S SIBLEY AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553553030",
            "telephone_number": "320-693-3233",
            "fax_number": "320-693-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S SIBLEY AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553553030",
            "telephone_number": "320-693-3233",
            "fax_number": "320-693-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TASHA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield, MN

Sources for this page

Verify at the official NPI Registry.