Individual provider Active NPI

Amanda J Kittelson, PA-C

  • Physician Assistant
  • Fargo, ND
National Provider Identifier
1922329903
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1073 Issued in ND
Practice address
5257 27TH St S Ste 201
Fargo, ND 58104-7782
Phone
(701) 356-5503
Fax
(701) 364-9781
NPI assigned
Jun 14, 2010
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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 11131 MN
Physician Assistant 363A00000X 1073 ND Primary

Addresses

Primary practice location

5257 27TH St S Ste 201
Fargo, ND 58104-7782

Mailing address

5257 27TH St S Ste 201
Fargo, ND 58104-7782
Phone (701) 356-5503

Other names 1

  • Amanda Frank Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address akittelson190441@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100830000015 ND Practitioner - Physician Assistant 2163546029 Reassigns benefits to 3 organizations
I20121228000453 MN Practitioner - Physician Assistant 2163546029 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians
Innovis Health LLCGroup PAC ID 9931298155, shared by 7 NPIs, 561 clinicians
Altaire Clinic PLLCGroup PAC ID 5698103554, 5 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

1720 University Dr S
Fargo, ND 58103-4940
Phone (701) 234-2000

208 Oppegard Ave NW
Twin Valley, MN 56584-4038
Phone (218) 584-5181

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

3902 13TH Ave S
Suite 3704
Fargo, ND 58103-7512
Phone (701) 364-6600

4110 51St Ave S
Fargo, ND 58104-7776
Phone (701) 364-3100

5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575

5257 27TH St S
Suite 201
Fargo, ND 58104-7782
Phone (701) 356-5503

720 Main Ave
Moorhead, MN 56560-2752
Phone (218) 359-0399

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health LLC CurrentSince Sep 8, 2025 Accepting new patients
Sanford Medical Center Fargo CurrentSince Sep 23, 2024 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients
Innovis Health, LLC CurrentSince Sep 8, 2025 Accepting new patients
River's Edge Hospital & Clinic CurrentSince Jan 1, 2022 Accepting new patients
Allina Health System CurrentSince Nov 1, 2016 Accepting new patients
Sanford Medical Center Fargo CurrentSince Sep 23, 2024 Accepting new patients
Innovis Health LLC CurrentSince Sep 8, 2025 Accepting new patients
Allina Health System CurrentSince Nov 1, 2016 Accepting new patients
Sanford Clinic North Past Accepting new patients
Hans Bjellum MD PC Past Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

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

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

1900 Sunrise Dr
Saint Peter, MN 56082
Phone (507) 931-2200

208 Oppegard Ave NW
Twin Valley, MN 56584
Phone (218) 584-5181

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

1720 University Dr S
Fargo, ND 58103
Phone (701) 280-4140

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

4476 31st Ave S
Fargo, ND 58104
Phone (701) 234-9400

4622 40th Ave S
Fargo, ND 58104
Phone (701) 232-6211

4622 40th Ave S
#7
Fargo, ND 58104
Phone (701) 364-2909

5225 23rd Ave S
Fargo, ND 58104
Phone (701) 234-5933

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

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 6

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": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1922329903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5257 27TH ST S STE 201",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047782",
            "telephone_number": "701-356-5503",
            "fax_number": "701-364-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5257 27TH ST S STE 201",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047782",
            "telephone_number": "701-356-5503",
            "fax_number": "701-364-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTELSON",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11131",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "1073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akittelson190441@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "akittelson190441@direct.centracare.com",
            "address_1": "Carris Health-Redwood",
            "address_2": "100 Fallwood Road",
            "city": "Redwood Falls",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "FRANK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.