NPIMap

Individual provider Active NPI

Mikayla Ellen Siemsen, CNP

  • Primary Care Nurse Practitioner
  • Zimmerman, MN
National Provider Identifier
1992537393
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
11970 Issued in MN
Practice address
12025 276TH Ave NW
Zimmerman, MN 55398-8923
Phone
(763) 350-6676
NPI assigned
Aug 15, 2024
Last updated
May 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 11970 MN Primary

Addresses

Primary practice location

12025 276TH Ave NW
Zimmerman, MN 55398-8923

Mailing address

200 Elm St N
Onamia, MN 56359-7901
Phone (320) 532-3154

Other identifiers 1

IdentifierTypeStateIssuer
11970OtherMNLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241107002823 MN Practitioner - Nurse Practitioner 9830623255 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mille Lacs Health SystemGroup PAC ID 4789577834, 47 clinicians

Practice addresses (Care Compare)

200 Elm St N
Onamia, MN 56359-7901
Phone (320) 532-3154

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mille Lacs Health System Current Accepting new patients
Mille Lacs Health System Current Accepting new patients
Mille Lacs Health System Current Accepting new patients
Mille Lacs Health System CurrentSince May 9, 2025 Accepting new patients
Mille Lacs Health System CurrentSince May 9, 2025 Accepting new patients
Select Urgent Care LLC CurrentSince Jan 28, 2025 Accepting new patients
Revitalize Your Wellness PastSince Aug 18, 2024 Accepting new patients

Locations

27378 State Highway 18
Garrison, MN 56450
Phone (320) 692-5599

190 Central Ave S
Milaca, MN 56353
Phone (224) 487-4368

200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750

12520 Fremont Ave
Ste 100
Zimmerman, MN 55398

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28265/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 7

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": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1992537393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ELM ST N",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563597901",
            "telephone_number": "320-532-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12025 276TH AVE NW",
            "city": "ZIMMERMAN",
            "state": "MN",
            "postal_code": "553988923",
            "telephone_number": "763-350-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEMSEN",
        "first_name": "MIKAYLA",
        "middle_name": "ELLEN",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "11970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "11970",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zimmerman, MN

Sources for this page

Verify at the official NPI Registry.