DR. LISA MARIE ANDERSON PHD
NPI 1114504123
Psychologist - Clinical in Maple Grove, MN
About Dr. Lisa Marie Anderson Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. LISA MARIE ANDERSON PHD (NPI 1114504123) is an individual clinical provider in Maple Grove, Minnesota, licensed in Minnesota (LP6534) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in St Louis Park.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Lisa Marie Anderson Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
5Medicare enrollment records show Lisa Anderson reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Maple Grove, MN 55369
- Reassigned Medicare billing, Minnesota enrollment
- 3,633 clinicians in this Medicare group
Minneapolis, MN 55411
- Reassigned Medicare billing, Minnesota enrollment
- 1,453 clinicians in this Medicare group
Minneapolis, MN 55454
- Reassigned Medicare billing, Minnesota enrollment
- 4,038 clinicians in this Medicare group
Minneapolis, MN 55454
- Reassigned Medicare billing, Minnesota enrollment
- 2,373 clinicians in this Medicare group
Minneapolis, MN 55455
- Reassigned Medicare billing, Minnesota enrollment
- 1,662 clinicians in this Medicare group
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 55369 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MAPLE GROVE, MN 55369
MAPLE GROVE, MN 55369
MAPLE GROVE, MN 55369
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Lisa Anderson's NPI number?
The NPI number for Lisa Anderson is 1114504123. It was assigned to this individual provider in the NPPES registry on March 25, 2021.
Where is Lisa Anderson located?
Lisa Anderson practices at 9600 Upland Ln N Ste 110, Maple Grove, MN 55369. The listed phone number is (952) 993-6200.
What is Lisa Anderson's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Lisa Anderson enrolled in Medicare?
Yes. Lisa Anderson is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Lisa Anderson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Anderson reassigns Medicare benefits to 5 organizations: Fairview Express Care (Maple Grove, MN), University Of Minnesota Physicians (Minneapolis, MN), Fairview Health Services (Minneapolis, MN), Fairview Specialty Services (Minneapolis, MN) and University Of Minnesota Health Clinics And Surgery Center Inc (Minneapolis, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lisa Anderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Lisa Anderson accept?
Health plans from Medica and Sanford Health Plan list Lisa Anderson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Lisa Anderson was last updated on October 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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.
# Dr. Lisa Marie Anderson, PHD · NPI 1114504123
Clinical provider in Maple Grove, Minnesota. Individual provider, active in the CMS NPPES registry since March 25, 2021.
## Identity
- **NPI:** 1114504123 (Entity type: Individual)
- **Enumerated:** March 25, 2021
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** LP6534 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 9600 UPLAND LN N STE 110, Maple Grove, MN 55369-4499
- **Phone:** (952) 993-6200
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Fairview Express Care (NPI 1255105011, Maple Grove, MN); University Of Minnesota Physicians (NPI 1366589962, Minneapolis, MN); Fairview Health Services (NPI 1013994359, Minneapolis, MN); Fairview Specialty Services (NPI 1043199334, Minneapolis, MN); University Of Minnesota Health Clinics And Surgery Center Inc (NPI 1003485004, Minneapolis, MN) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 30, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1114504123) · Data from the CMS NPPES public registry.