Individual provider Active NPI

Ashley Ertelt, CNP

  • Nurse Practitioner
  • Eden Prairie, MN
National Provider Identifier
1881275543
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8092 Issued in MN
Practice address
7595 Anagram Dr
Eden Prairie, MN 55344-7399
Phone
(612) 573-2200
Fax
(612) 573-2274
NPI assigned
Apr 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 8092 MN Primary

Addresses

Primary practice location

7595 Anagram Dr
Eden Prairie, MN 55344-7399

Mailing address

7595 Anagram Dr
Eden Prairie, MN 55344-7399
Phone (612) 573-2200

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
I20210504002332 MN Practitioner - Nurse Practitioner 3072922012 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8092MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care Current Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jun 21, 2025 Accepting new patients
North Memorial Health Care CurrentSince Jun 1, 2021 Accepting new patients
Consulting Radiologists, LTD PastSince May 15, 2021 Accepting new patients

Locations

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

1540 Lake St S
Forest Lake, MN 55025
Phone (651) 464-7100

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

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

913 E 26th St
Ste 304
Minneapolis, MN 55404
Phone (612) 863-3200

2855 Campus Dr
Ste 610
Plymouth, MN 55441
Phone (612) 333-4822

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

Interoperability endpoints

  • Direct secure messaging: aertelt554197@excellian.direct.allina.com

Organizations & group practices 7

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1881275543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7595 ANAGRAM DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447399",
            "telephone_number": "612-573-2200",
            "fax_number": "612-573-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7595 ANAGRAM DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447399",
            "telephone_number": "612-573-2200",
            "fax_number": "612-573-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTELT",
        "first_name": "ASHLEY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "8092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.