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KACIE ROTH CNP
NPI 1801419700
Nurse Practitioner - Psychiatric/Mental Health in Minneapolis, MN

Active since May 26, 2020PECOS Enrolled
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 273-4000 Get Directions Write a Review

NPPES record last updated: November 17, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 17, 2021, May 26, 2020 (2 updates tracked since 2020).

About Kacie Roth Cnp NPPES

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

KACIE ROTH CNP (NPI 1801419700) is an individual psychiatric/mental health provider in Minneapolis, Minnesota, licensed in Minnesota (8473) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801419700
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameKACIE ROTHCredential: CNP
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450
Mailing Address2450 Riverside AveMinneapolis, MN 55454-1450
Phone(612) 273-4000
Sole ProprietorNo
Enumeration DateMay 26, 2020
Last NPPES UpdateNovember 17, 20212 updates tracked since enumeration
NPPES CertifiedNovember 17, 2021
✔ NPI 1801419700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MN · 8473
Also ListedRegistered NurseTaxonomy 163W00000X · License 2413226 (MN)
2450 RIVERSIDE AVE, Minneapolis, MN 55454
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kacie Roth Cnp 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.

Medicare Billing Reassignments

5

Medicare enrollment records show Kacie Roth reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Express Care
Same address
Clinic/Center
2450 RIVERSIDE AVE, STE F140
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 3,633 clinicians in this Medicare group
NPI 1841428745 (612) 672-6999
Fairview Health Services
Same address
General Acute Care Hospital
2450 RIVERSIDE AVE, OUTREACH LAB DEPARTMENT
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 4,038 clinicians in this Medicare group
NPI 1316008212 (612) 273-7838
Fairview Specialty Services
Same address
Physical Therapy
2450 RIVERSIDE AVE
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,373 clinicians in this Medicare group
NPI 1043199334 (855) 324-7843
Healtheast Medical Research Institute
3.3 mi
Internal Medicine
1700 UNIVERSITY AVE W, 6TH FLOOR WEST
Saint Paul, MN 55104
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,361 clinicians in this Medicare group
NPI 1508191552 (651) 232-2273
Range Regional Health Services
169 mi
General Acute Care Hospital
750 E 34TH ST
Hibbing, MN 55746
  • Reassigned Medicare billing, Minnesota enrollment
  • 707 clinicians in this Medicare group
NPI 1356321699 (218) 262-4881

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 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
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
DR. KATHLEEN F SADAK MD
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-6402
DR. ADMATHA MUTHYALA WINFRED MD
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
KELLY SCHELLER WILLIAMS
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3216
MRS. MARY SUSAN CLIPP CPNP-AC
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 365-3100
DANIEL TESFAYE KEBED MD
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MS. CHELSEA ANJELICA MIELKE PA-C
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MRS. JESSICA LYNN MCADAM
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-8383

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 Kacie Roth's NPI number?

The NPI number for Kacie Roth is 1801419700. It was assigned to this individual provider in the NPPES registry on May 26, 2020.

Where is Kacie Roth located?

Kacie Roth practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 273-4000.

What is Kacie Roth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kacie Roth enrolled in Medicare?

Yes. Kacie Roth is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kacie Roth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kacie Roth reassigns Medicare benefits to 5 organizations: Fairview Express Care (Minneapolis, MN), Fairview Health Services (Minneapolis, MN), Fairview Specialty Services (Minneapolis, MN), Healtheast Medical Research Institute (Saint Paul, MN) and Range Regional Health Services (Hibbing, 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 Kacie Roth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kacie Roth accept?

Health plans from Sanford Health Plan list Kacie Roth 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 Kacie Roth was last updated on November 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.