Individual provider Active NPI

Alexandra Czarnetzki, DNP

  • Family Nurse Practitioner
  • Golden Valley, MN
National Provider Identifier
1982375457
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8562 Issued in MN
Practice address
1415 Lilac Dr N Ste 190
Golden Valley, MN 55422-4544
Phone
(763) 267-8701
NPI assigned
Sep 24, 2021
Last updated
Dec 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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 8562 MN Primary

Addresses

Primary practice location

1415 Lilac Dr N Ste 190
Golden Valley, MN 55422-4544

Mailing address

464 2ND St Ste 204
Excelsior, MN 55331-2015
Phone (612) 787-8408

Other names 1

  • Alexandra Buelow Former name

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
I20211011000420 MN Practitioner - Nurse Practitioner 0648678300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation Medicine Associates LLCGroup PAC ID 9335465558, 10 clinicians

Practice addresses (Care Compare)

464 2ND St
Suite 204
Excelsior, MN 55331-2015
Phone (612) 787-8408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Medicine Associates, LLC CurrentSince Nov 7, 2023 Accepting new patients

Locations

2001 Midwest Rd
Ste 100
Oak Brook, IL 60523
Phone (630) 426-9501

464 2nd St
Ste 204
Excelsior, MN 55331
Phone (612) 787-8404

Organizations & group practices 1

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": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1982375457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 2ND ST STE 204",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553312015",
            "telephone_number": "612-787-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZARNETZKI",
        "first_name": "ALEXANDRA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "BUELOW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.