Individual provider Active NPI

Angela Ristau, APRN, CNP

  • Family Nurse Practitioner
  • Mankato, MN
National Provider Identifier
1912664145
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7914 Issued in MN
Practice address
309 Holly LN
Mankato, MN 56001-5422
Phone
(507) 388-2120
NPI assigned
Nov 22, 2021
Last updated
Feb 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7914 MN Primary

Addresses

Primary practice location

309 Holly LN
Mankato, MN 56001-5422

Mailing address

9488 393Rd Ave
Waseca, MN 56093-4110
Phone (507) 995-3113

Other identifiers 1

IdentifierTypeStateIssuer
F09200846MedicaidMN

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
I20230209000287 MN Practitioner - Nurse Practitioner 9436521994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Door Health CenterGroup PAC ID 7012944085, 8 clinicians

Practice addresses (Care Compare)

309 Holly LN
Mankato, MN 56001-5422
Phone (507) 388-2120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Health Center CurrentSince Oct 28, 2022 Accepting new patients
Open Door Health Center CurrentSince Oct 28, 2022 Accepting new patients

Locations

309 Holly Ln
Mankato, MN 56001
Phone (507) 388-2120

Interoperability endpoints

  • Direct secure messaging: angelaristau@odhc.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1912664145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9488 393RD AVE",
            "city": "WASECA",
            "state": "MN",
            "postal_code": "560934110",
            "telephone_number": "507-995-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 HOLLY LN",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015422",
            "telephone_number": "507-388-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISTAU",
        "first_name": "ANGELA",
        "credential": "APRN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-22",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F09200846",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.