NORTHERN LIGHTS HEALTH LLC
NPI 1316581440
Nurse Practitioner - Primary Care in Waconia, MN
About Northern Lights Health Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHERN LIGHTS HEALTH LLC (NPI 1316581440) is a healthcare organization registered as a primary care in Waconia, Minnesota and active in the NPI registry since October 2019. The organization holds a CLIA Waiver certificate valid through November 8, 2026 and lists Nicole M Siddons, Co-founder, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Northern Lights Health Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
18Medicare enrollment records show 18 clinicians reassign Medicare billing to Northern Lights Health LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (18)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 24D2199463
Northern Lights Health · Waconia, MNFrequently 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 Northern Lights Health LLC's NPI number?
The NPI number for Northern Lights Health LLC is 1316581440. It was assigned to this organization in the NPPES registry on October 31, 2019.
Where is Northern Lights Health LLC located?
Northern Lights Health LLC is located at 212 W Lake St, Waconia, MN 55387. The listed phone number is (920) 217-9035.
What is Northern Lights Health LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Northern Lights Health LLC enrolled in Medicare?
Yes. Northern Lights Health LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Northern Lights Health LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 18 clinicians in 5 Medicare specialties reassign their Medicare billing to Northern Lights Health LLC. A 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 the clinician's services. The largest specialties are Nurse Practitioner (14), Emergency Medicine (1) and Family Practice (1). Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Northern Lights Health LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D2199463) is associated with this NPI, valid through November 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Northern Lights Health LLC accept?
Health plans from Anthem Blue Cross and Blue Shield list Northern Lights Health LLC 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 Northern Lights Health LLC was last updated on December 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Northern Lights Health Llc · NPI 1316581440
Primary Care organization in Waconia, Minnesota. Organization record, active in the CMS NPPES registry since October 31, 2019.
## Identity
- **NPI:** 1316581440 (Entity type: Organization)
- **Enumerated:** October 31, 2019
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **Organization subpart:** No
- **Authorized official:** Nicole Siddons, CO-FOUNDER
## Practice location
- **Address:** 212 W LAKE ST, Waconia, MN 55387-1014
- **Phone:** (920) 217-9035
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 18 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (14), Emergency Medicine (1), Family Practice (1); 3 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 22, 2019
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1316581440) · Data from the CMS NPPES public registry.