NPIMap

Individual provider Active NPI

Aleathea Rae Anderson, PA-C

  • Physician Assistant
  • Long Prairie, MN
National Provider Identifier
1942356944
Registry record updated May 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10212 Issued in MN
Practice address
20 SE Ninth Street
Centracare Health System-Long Prairie
Long Prairie, MN 56347-1404
Phone
(320) 732-2141
Fax
(320) 732-6913
NPI assigned
Jan 25, 2007
Last updated
May 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2012

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 10212 MN Primary
Medical Physician Assistant 363AM0700X 2089 WI

Addresses

Primary practice location

20 SE Ninth Street
Centracare Health System-Long Prairie
Long Prairie, MN 56347-1404

Mailing address

20 SE Ninth Street
Centracare Health System-Long Prairie
Long Prairie, MN 56347-1404
Phone (320) 732-2141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070212000555 WI Practitioner - Physician Assistant 8527060052 Reassigns benefits to 2 organizations
I20080508000076 MN Practitioner - Physician Assistant 8527060052 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians
Pine Medical CenterGroup PAC ID 3870406945, 17 clinicians

Practice addresses (Care Compare)

1413 Hwy 33 S
Cloquet, MN 55720-2626
Phone (218) 337-4000

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

420 E 1St St
Duluth, MN 55805-1901
Phone (218) 786-8364

45 Lady Luck Dr
Hinckley, MN 55037-6419
Phone (320) 279-8600

705 Lundorff Dr
Sandstone, MN 55072-5099
Phone (320) 245-2211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2089WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Hospital of Superior CurrentSince Jan 1, 2026 Accepting new patients
The Duluth Clinic LTD CurrentSince Aug 1, 2022 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 1, 2022 Accepting new patients
Essentia Health Moose Lake CurrentSince Mar 13, 2023 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Mar 6, 2023 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients

Locations

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

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 11

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.

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336435200000",
    "number": "1942356944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SE NINTH STREET",
            "address_2": "CENTRACARE HEALTH SYSTEM-LONG PRAIRIE",
            "city": "LONG PRAIRIE",
            "state": "MN",
            "postal_code": "563471404",
            "telephone_number": "320-732-2141",
            "fax_number": "320-732-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SE NINTH STREET",
            "address_2": "CENTRACARE HEALTH SYSTEM-LONG PRAIRIE",
            "city": "LONG PRAIRIE",
            "state": "MN",
            "postal_code": "563471404",
            "telephone_number": "320-732-2141",
            "fax_number": "320-732-6913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ALEATHEA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2012-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10212",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "2089",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Prairie, MN

Sources for this page

Verify at the official NPI Registry.