Kendyl Marie Zeidler, APRN, A-GNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AG02220107 Issued in MN

Practice address

582 Cherry Dr
Waconia, MN 55387-4578

Phone

(952) 395-6850

Fax

(952) 395-6870

NPI assigned

Aug 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology Care Medical Cosmetic and Surgery PAGroup PAC ID 4385633767, 7 clinicians

Skin Professionals West PCGroup PAC ID 0941618771, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kzeidler@adc.emadirect.md

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.

• Advanced Dermatology Care Medical Cosmetic and Surgery PA

  • Dermatology Physician
  • White Bear Lake, MN
  • NPI 1073614558
  Medicare reassignment Care Compare group NPD
• Skin Professionals West, P.C.

  • Dermatology Physician
  • Waconia, MN
  • NPI 1992394944
  Medicare reassignment Care Compare group NPD
• Advanced Dermatology Care Medical Cosmetic and Surgery PA

  • Dermatology Physician
  • Stillwater, MN
  • NPI 1144486978
  NPD
• Advanced Dermatology Care Medical Cosmetic and Surgery PA

  • Dermatology Physician
  • Forest Lake, MN
  • NPI 1912158031
  NPD
• James P Wire MD PA

  • Specialist
  • Chaska, MN
  • NPI 1982621918
  NPD (past)

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

{
    "created_epoch": "1659830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1841927043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 CHERRY DR",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874578",
            "telephone_number": "952-395-6850",
            "fax_number": "952-395-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 CHERRY DR",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874578",
            "telephone_number": "952-395-6850",
            "fax_number": "952-395-6870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Saint Francis Ave Ste 250",
            "address_purpose": "LOCATION",
            "city": "Shakopee",
            "state": "MN",
            "postal_code": "553794383",
            "country_code": "US",
            "telephone_number": "952-395-6850",
            "fax_number": "952-395-6870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEIDLER",
        "first_name": "KENDYL",
        "middle_name": "MARIE",
        "credential": "APRN, A-GNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-07",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "AG02220107",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "AG02220107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfolska@darabiderm.com",
            "affiliation": "N",
            "address_1": "582 Cherry Dr",
            "city": "Waconia",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553874578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charlie Yanisch
• Robert Aaron Yost, M.D.
• Amanda Katherine Youngren, MS, LPCC
• Annika Zallek, OTR
• Kimberly K Zaun, HIS
• Hannah Zuengler

• Adult Health Nurse Practitioner in Waconia, MN
• Providers in Waconia, MN by specialty
• Adult Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.