Individual provider Active NPI

Carine Tiam

  • Nurse Practitioner
  • Buffalo, MN
National Provider Identifier
1831965920
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10997 Issued in MN
Practice address
755 Crossroads Campus Dr NE
Buffalo, MN 55313-5074
Phone
(763) 684-6300
Fax
(763) 684-6305
NPI assigned
Nov 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10997 MN Primary

Addresses

Primary practice location

755 Crossroads Campus Dr NE
Buffalo, MN 55313-5074

Mailing address

755 Crossroads Campus Dr NE
Buffalo, MN 55313-5074
Phone (763) 684-6300

Other names 1

  • Francoise Carine Kemda Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231219000187 MN Practitioner - Nurse Practitioner 4587014485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
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)

755 Crossroads Campus Dr NE
Suite 100
Buffalo, MN 55313-5074
Phone (763) 684-6300

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10997MNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Feb 1, 2023 Accepting new patients
Allina Health System CurrentSince Feb 1, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Past Accepting new patients

Locations

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

755 Crossroads Campus Dr NE
Buffalo, MN 55313
Phone (763) 684-6300

755 Crossroads Campus Dr NE
Ste 100
Buffalo, MN 55313
Phone (763) 684-6300

11269 Jefferson Hwy N
Champlin, MN 55316
Phone (763) 236-0600

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

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

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

5565 Blaine Ave
South St Paul, MN 55076
Phone (651) 241-9400

8675 Valley Creek Rd
Woodbury, MN 55125
Phone (651) 241-3000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1831965920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 CROSSROADS CAMPUS DR NE",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553135074",
            "telephone_number": "763-684-6300",
            "fax_number": "763-684-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 CROSSROADS CAMPUS DR NE",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553135074",
            "telephone_number": "763-684-6300",
            "fax_number": "763-684-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIAM",
        "first_name": "CARINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "10997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FRANCOISE",
            "last_name": "KEMDA",
            "middle_name": "CARINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buffalo, MN

Sources for this page

Verify at the official NPI Registry.