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KALISA RURINDA NDIKUBWIMANA DNP-CNP
NPI 1427929124
Nurse Practitioner - Family in Maplewood, MN

Active since September 16, 2025PECOS EnrolledAccepts Medicare Assignment
1725 LEGACY PKWY E STE 100, MAPLEWOOD, MN 55109(952) 234-8580(952) 841-2346 Get Directions Write a Review

NPPES record last updated: September 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kalisa Rurinda Ndikubwimana Dnp-cnp NPPES

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

KALISA RURINDA NDIKUBWIMANA DNP-CNP (NPI 1427929124) is an individual family provider in Maplewood, Minnesota, licensed in Minnesota (13025) and active in the NPI registry since September 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1427929124
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameKALISA RURINDA NDIKUBWIMANACredential: DNP-CNP
Location Address1725 LEGACY PKWY E STE 100Maplewood, MN 55109-5434
Mailing Address1725 Legacy Pkwy E Ste 100Maplewood, MN 55109-5434 · (952) 234-8580 · Fax (952) 841-2346
Phone(952) 234-8580
Fax(952) 841-2346
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateSeptember 16, 2025
NPPES CertifiedSeptember 15, 2025
✔ NPI 1427929124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MN · 13025
Also ListedNurse PractitionerTaxonomy 363L00000X · License 13025 (MN)
1725 LEGACY PKWY E STE 100, Maplewood, MN 55109
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kalisa Rurinda Ndikubwimana Dnp-cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214428135
PECOS Enrollment IDI20251118002969
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55109 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 3

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

DR. GREGORY CREWDSON DO
Pain Medicine (Interventional Pain Medicine)
1725 LEGACY PKWY E STE 100
MAPLEWOOD, MN 55109
Ramsey County (952) 260-1381
ANDREW J WILL MD PA
Clinic/Center (Pain)
1725 LEGACY PKWY E STE 100
MAPLEWOOD, MN 55109
Ramsey County (952) 841-2345
BETHANIE MICHELLE MILLER CNP
Nurse Practitioner (Family)
1725 LEGACY PKWY E STE 100
MAPLEWOOD, MN 55109
Ramsey County (952) 841-2345

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 Kalisa Ndikubwimana's NPI number?

The NPI number for Kalisa Ndikubwimana is 1427929124. It was assigned to this individual provider in the NPPES registry on September 16, 2025.

Where is Kalisa Ndikubwimana located?

Kalisa Ndikubwimana practices at 1725 Legacy Pkwy E Ste 100, Maplewood, MN 55109. The listed phone number is (952) 234-8580.

What is Kalisa Ndikubwimana's specialty?

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

Is Kalisa Ndikubwimana enrolled in Medicare?

Yes. Kalisa Ndikubwimana is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kalisa Ndikubwimana was last updated on September 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.