Kelsey Kostreba, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

13172 Issued in MN

Practice address

9825 Hospital Dr Ste 105
Maple Grove, MN 55369-4769

Phone

(763) 780-6699

Fax

(763) 420-0500

NPI assigned

Oct 29, 2019

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

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Specialists in General Surgery, LTDGroup PAC ID 2466416128, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214
• Buffalo Hospital Hospital, Buffalo, MN, CCN 240076
• North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkostreba410372@excellian.direct.allina.com
• Direct secure messaging: kelsey.kostreba@sgs.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/DEAHBA/Endpoint/DEAHBA

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.

• Specialists in General Surgery, LTD

  • Specialist
  • Maple Grove, MN
  • NPI 1780649665
  Medicare reassignment Care Compare group
• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment
• Allina Health System

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment
• North Memorial Health Care

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Medicare reassignment
• Allina Health System

  • Specialist
  • St Paul, MN
  • NPI 1447550702
  NPD
• Allina Health System

  • Urgent Care Clinic/Center
  • Lakeville, MN
  • NPI 1710754965
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• North Memorial Health Care

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1568893220
  NPD
• Allina Health System

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1467758813
  NPD (past)

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

• Allina Health System

  • General Acute Care Hospital
  • Buffalo, MN
  • NPI 1538123567
  Care Compare affiliation
• Maple Grove Hospital Corporation

  • General Acute Care Hospital
  • Maple Grove, MN
  • NPI 1225272552
  Care Compare affiliation
• North Memorial Health Care

  • Ambulance
  • Brooklyn Center, MN
  • NPI 1538195912

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • Medical Specialty Clinic/Center
  • Robbinsdale, MN
  • NPI 1699953000

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Care Compare affiliation

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1033753546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR STE 105",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694769",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR STE 105",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694769",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 Bottineau Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Crystal",
            "state": "MN",
            "postal_code": "554293184",
            "country_code": "US",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 Highway 25 N Ste 120",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "MN",
            "postal_code": "553131930",
            "country_code": "US",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "480 Osborne Rd NE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fridley",
            "state": "MN",
            "postal_code": "554322781",
            "country_code": "US",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 39th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554214379",
            "country_code": "US",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1495 County Road 101 N",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554473078",
            "country_code": "US",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3366 Oakdale Ave N Ste 200",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "554222962",
            "country_code": "US",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15450 Highway 7 Ste 225",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553453522",
            "country_code": "US",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11855 Ulysses St NE Ste 210",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554344181",
            "country_code": "US",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7600 France Ave S Ste 4100",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554356027",
            "country_code": "US",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7373 France Ave S Ste 408",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554354549",
            "country_code": "US",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6565 France Ave S Ste 350",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352159",
            "country_code": "US",
            "telephone_number": "763-780-6699",
            "fax_number": "763-420-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTREBA",
        "first_name": "KELSEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "13172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Konz
• Heidi Kopacek, PSYD, LP
• Mark Korthals, OD
• Bridget Kosak, PA-C
• David M. Kosfeld, LMFT
• Nora Caroline Kotlowski
• Lawrence Joseph Kotok, DDS
• Kottemann Orthodontics PA
• Scott Kottemann
• William Joseph Kottemann, DDS, MS

• Surgical Physician Assistant in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Surgical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.