Individual provider Active NPI

Sydney Gunderson

  • Family Nurse Practitioner
  • Chanhassen, MN
National Provider Identifier
1922787092
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10433 Issued in MN
Practice address
7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone
(952) 934-0570
NPI assigned
Jul 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 242946-9 MN
Family Nurse Practitioner 363LF0000X 10433 MN Primary

Addresses

Primary practice location

7907 Powers Blvd
Chanhassen, MN 55317-9502

Mailing address

1108 Maplewood Dr
Delano, MN 55328-9262
Phone (952) 686-8848

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
I20231031002275 MN Practitioner - Nurse Practitioner 2062868870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570

916 Saint Peter Ave E
Delano, MN 55328-2813
Phone (952) 442-7800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10433MNMDGeneral Practice Dentistry
242946-9MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Medical Center CurrentSince Aug 21, 2023 Accepting new patients
Ridgeview Medical Center Current Accepting new patients

Locations

165 W Commerce Dr
Belle Plaine, MN 56011
Phone (952) 777-5661

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

916 Saint Peter Ave E
Delano, MN 55328
Phone (763) 972-9172

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1922787092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 MAPLEWOOD DR",
            "city": "DELANO",
            "state": "MN",
            "postal_code": "553289262",
            "telephone_number": "952-686-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7907 POWERS BLVD",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179502",
            "telephone_number": "952-934-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "SYDNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "242946-9",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "10433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chanhassen, MN

Sources for this page

Verify at the official NPI Registry.