Kassandra Elizabeth Anderson, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Tyler, Minnesota. Her current practice location is
240 Willow St, Tyler, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(507) 247-5521.
Kassandra Elizabeth Anderson is licensed to practice in Minnesota (license number 9047) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1619626652.
Provider's Profile
| Full Name | Kassandra Elizabeth Anderson |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 240 Willow St, Tyler, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1619626652
- Provider Enumeration Date: 03/18/2022
- Last Update Date: 03/18/2022
Medicare PECOS Information:
- PECOS PAC ID: 7214318708
- Enrollment ID: I20220714002443
Medical Identifiers
Medical identifiers for Kassandra Elizabeth Anderson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619626652 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 9047 (Minnesota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kassandra Elizabeth Anderson allows following entities to bill medicare on her behalf.
| Entity Name | Avera Tyler |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1801840517
PECOS PAC ID: 9638088537
Enrollment ID: O20170630001868 |
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| Entity Name | Avera Granite Falls |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1700429644
PECOS PAC ID: 1456784560
Enrollment ID: O20200106000646 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kassandra Elizabeth Anderson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kassandra Elizabeth Anderson, FNP-C
203 Maye St,
Tyler, MN 56178-9490
Ph: (605) 838-7118 | Kassandra Elizabeth Anderson, FNP-C
240 Willow St,
Tyler, MN 56178-1201
Ph: (507) 247-5521 |
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