Individual provider Active NPI

Chiara Teresa Kristina Coll Andahazy, PA-C

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1912558651
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13090 Issued in MN
Practice address
720 Washington Ave SE Ste 200
Minneapolis, MN 55414-2924
Phone
(612) 884-0600
NPI assigned
Sep 24, 2019
Last updated
Apr 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 490423 WI
Physician Assistant 363A00000X 13090 MN Primary

Addresses

Primary practice location

720 Washington Ave SE Ste 200
Minneapolis, MN 55414-2924

Mailing address

302 Valley CMNS
Hudson, WI 54016-6102
Phone (715) 410-9596

Other practice location 1

2321 Stout Rd
Menomonie, WI 54751-7003
Phone (715) 235-5531

Other practice location 2

1221 Whipple St
Eau Claire, WI 54703-5270
Phone (715) 583-8331

Other practice location 3

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

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
I20210706001618 MN Practitioner - Physician Assistant 0749613933 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians

Practice addresses (Care Compare)

111 SE 3Rd St
Grand Rapids, MN 55744-3663
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Phone (218) 326-3401

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (855) 324-7843

1747 Beam Ave
Suite 100
Maplewood, MN 55109-1128
Phone (651) 232-7800

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

45 10TH St W
Saint Paul, MN 55102-1062

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

6545 France Ave S
Suite 450
Edina, MN 55435-2122
Phone (952) 924-1520

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-6353

919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
88.69
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13090MNMDPhysician Assistant
490423WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Aug 13, 2021 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Oct 1, 2021 Accepting new patients
Fairview Express Care CurrentSince Aug 13, 2021 Accepting new patients
Healtheast Medical Research Institute Single Specialty CurrentSince Aug 13, 2021 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Aug 13, 2021 Accepting new patients
Fairview Express Care Single Specialty CurrentSince Aug 13, 2021 Accepting new patients
University of Minnesota Physicians CurrentSince Aug 13, 2021 Accepting new patients
Fairview Health Services Single Specialty Past Accepting new patients

Locations

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

720 Washington Ave SE
Ste 200
Minneapolis, MN 55414
Phone (612) 273-8383

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0331

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: candahazy681046@fairview.direct-ci.com

Organizations & group practices 14

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.

View all 14

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": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1912558651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 VALLEY CMNS",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540166102",
            "telephone_number": "715-410-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE STE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142924",
            "telephone_number": "612-884-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2321 Stout Rd",
            "address_purpose": "LOCATION",
            "city": "Menomonie",
            "state": "WI",
            "postal_code": "547517003",
            "country_code": "US",
            "telephone_number": "715-235-5531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Whipple St",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547035270",
            "country_code": "US",
            "telephone_number": "715-583-8331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6401 France Ave S",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352104",
            "country_code": "US",
            "telephone_number": "952-924-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDAHAZY",
        "first_name": "CHIARA",
        "middle_name": "TERESA KRISTINA COLL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "490423",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.