ALEXANDRA ROSE LAUDERDALE
NPI 1639998552
Nurse Practitioner - Neonatal in Minneapolis, MN

Q: What is Alexandra Lauderdale's NPI number?

The NPI number for Alexandra Lauderdale is 1639998552. It was assigned to this individual provider in the NPPES registry on October 8, 2024.

Q: What is Alexandra Lauderdale's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, with taxonomy code 363LN0000X.

Active since October 08, 2024PECOS Enrolled

2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 624-0720 Get Directions Write a Review

NPPES record last updated: October 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 10, 2025, Oct 8, 2024 (2 updates tracked since 2024).

On this page

About Alexandra Rose Lauderdale NPPES

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

ALEXANDRA ROSE LAUDERDALE (NPI 1639998552) is an individual neonatal provider in Minneapolis, Minnesota, licensed in Minnesota (12263) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS and maintains a secondary practice location in Maplewood.

NPPES Registry Identity

NPI1639998552

Entity TypeIndividualFemale

Primary Taxonomy363LN0000X

Provider Legal NameALEXANDRA ROSE LAUDERDALE

Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450

Mailing Address1318 S Mccoy StAberdeen, SD 57401-7843 · (605) 377-4479

Phone(612) 624-0720

Sole ProprietorNo

Enumeration DateOctober 8, 2024

Last NPPES UpdateOctober 10, 20252 updates tracked since enumeration

NPPES CertifiedOctober 10, 2025

✔ NPI 1639998552 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363LN0000X

License✔ Licensed in MN · 12263

Also ListedRegistered Nurse · Neonatal Intensive CareTaxonomy 163WN0002X · License 2477446 (MN)

2450 RIVERSIDE AVE, Minneapolis, MN 55454

Open in Google Maps ↗

Secondary Practice Location 1

Location 11575 Beam AveMaplewood, MN 55109-1126 · Phone (651) 232-7000

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alexandra Rose Lauderdale 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55454 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.

MICHELLE IRENE GRAY

Rehabilitation Practitioner