Kayla Mae Holm, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1200577 Issued in MN

Practice address

15650 Cedar Ave
Apple Valley, MN 55124-7283

Phone

(952) 997-4100

NPI assigned

Feb 10, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kayla Mae Mack Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Fairview Home Health - West, LLC Home health agency, Saint Paul, MN, CCN 247078
• M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207
• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kholm242277@fairview.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment Care Compare group
• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Healtheast Medical Research Institute

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1508191552
  NPD
• Healtheast Medical Research Institute

  • Surgery Physician
  • Maplewood, MN
  • NPI 1750791810
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Accentcare Fairview Home Health - West, LLC

  • Home Health Agency
  • Saint Paul, MN
  • NPI 1477169233
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1225199128
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1245217520
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1003513979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15650 CEDAR AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247283",
            "telephone_number": "952-997-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15650 CEDAR AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247283",
            "telephone_number": "952-997-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM",
        "first_name": "KAYLA",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1200577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "MACK",
            "middle_name": "MAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather Hislop-Anderson, LPCC
• Linh Hoang
• Mimi KN Hoang, DDS
• Jennifer Ellen Hoffman, MSW, LICSW
• Kelsey Marie Hogan
• Shawn Holm
• Mel P Homan, OTR/L
• Sarah Mean Hong, PT, DPT
• Hope & New Life Healthcare
• Hope and New Life Health Care

• Physician Assistant in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.