KELLY L NGUYEN APRN
NPI 1063883338
Nurse Practitioner - Family in Andover, MN

Q: What is Kelly Nguyen's NPI number?

The NPI number for Kelly Nguyen is 1063883338. It was assigned to this individual provider in the NPPES registry on October 13, 2015.

Q: What is Kelly Nguyen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Nguyen was last updated on April 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 13, 2015PECOS Enrolled

13819 HANSON BLVD NW, ANDOVER, MN 55304(763) 392-4001(763) 862-2091 Get Directions Write a Review

NPPES record last updated: April 4, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 4, 2019, Feb 19, 2016 (2 updates tracked since 2016).

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About Kelly L Nguyen Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY L NGUYEN APRN (NPI 1063883338) is an individual family provider in Andover, Minnesota, licensed in Minnesota (6445) and active in the NPI registry since October 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063883338

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKELLY L NGUYENCredential: APRN

Location Address13819 HANSON BLVD NWAndover, MN 55304-7608

Mailing Address13819 Hanson Blvd NwAndover, MN 55304-7608 · (763) 392-4001 · Fax (763) 862-2091

Phone(763) 392-4001

Fax(763) 862-2091

Sole ProprietorNo

Enumeration DateOctober 13, 2015

Last NPPES UpdateApril 4, 20192 updates tracked since enumeration

✔ NPI 1063883338 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in MN · 6445✔ Licensed in KY · 3009765

13819 HANSON BLVD NW, Andover, MN 55304

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Other Identifiers 2

Medicaid7100366930KY

Medicaid201332080IN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly L Nguyen Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Kelly Nguyen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Clinics

Same address

Multi-Specialty

13819 HANSON BLVD NW
Andover, MN 55304

Reassigned Medicare billing, Minnesota enrollment
2,302 clinicians in this Medicare group

NPI 1477734705 (763) 572-5700

Fairview Health Services

16 mi

General Acute Care Hospital

5200 FAIRVIEW BLVD
Wyoming, MN 55092

Reassigned Medicare billing, Minnesota enrollment
4,038 clinicians in this Medicare group

NPI 1083692941 (651) 982-7000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARITO M SANTOS MD

Family Medicine