AUTUMN OLIVIA KITZMANN LP, PSYD
NPI 1477199305
Psychologist - Clinical in New Brighton, MN

Q: What is Autumn Kitzmann's NPI number?

The NPI number for Autumn Kitzmann is 1477199305. It was assigned to this individual provider in the NPPES registry on November 26, 2019. The provider is also known as Autumn Olivia Dow LP, Psyd.

Q: What is Autumn Kitzmann's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Autumn Kitzmann was last updated on February 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since November 26, 2019PECOS Enrolled

1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112(651) 628-9566(651) 628-0411 Get Directions Write a Review

NPPES record last updated: February 19, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 9, 2025, Nov 4, 2025, Jul 9, 2024 and 2 more (5 updates tracked since 2019).

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About Autumn Olivia Kitzmann Lp, Psyd NPPES

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

AUTUMN OLIVIA KITZMANN LP, PSYD (NPI 1477199305) is an individual clinical provider in New Brighton, Minnesota, licensed in Minnesota (1477199305) and active in the NPI registry since November 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Eden Prairie, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1477199305

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameAUTUMN OLIVIA KITZMANNCredential: LP, PSYD

Location Address1900 SILVER LAKE RD NW STE 110New Brighton, MN 55112-1789

Mailing Address1900 Silver Lake Rd Nw Ste 110New Brighton, MN 55112-1789 · (651) 628-9566 · Fax (651) 628-0411

Phone(651) 628-9566

Fax(651) 628-0411

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateNovember 26, 2019

Last NPPES UpdateFebruary 19, 20265 updates tracked since enumeration

NPPES CertifiedFebruary 19, 2026

✔ NPI 1477199305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MN · 1477199305

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1900 SILVER LAKE RD NW STE 110, New Brighton, MN 55112

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Other Names 1

Former Name (1)Autumn Olivia Dow Lp, Psyd

Secondary Practice Location 1

Location 16640 Shady Oak Rd Ste 401Eden Prairie, MN 55344-7834 · Phone (715) 256-7166 · Fax (888) 427-8048

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Autumn Olivia Kitzmann Lp, Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911490198

PECOS Enrollment IDI20251205001174

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 Reassignment

Medicare enrollment records show Autumn Kitzmann reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Nystrom & Associates, Ltd

Same address

Clinical

1900 SILVER LAKE RD NW, SUITE 110
New Brighton, MN 55112

Reassigned Medicare billing, Minnesota enrollment
794 clinicians in this Medicare group

NPI 1396750188 (651) 628-9566

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 55112 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

$168.28 typical visit price

range $56.00 – $168.28

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

Most-billed visit code 99205

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.

DAVID HAWKINSON

Counselor (Mental Health)