Individual provider Active NPI

Kyah Fons Miles

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1043512445
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10832 Issued in MN
Practice address
280 Smith Ave N
Suite #600
Saint Paul, MN 55102-2424
Phone
(651) 241-7246
NPI assigned
Nov 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10832 MN Primary

Addresses

Primary practice location

280 Smith Ave N
Suite #600
Saint Paul, MN 55102-2424

Mailing address

280 Smith Ave N
Suite #600
Saint Paul, MN 55102-2424
Phone (651) 241-7246

Other names 1

  • Kyah Sue Fons Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110405000095 MN Practitioner - Physician Assistant 0941484653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Allergy and Asthma LLCGroup PAC ID 9335234160, 2 clinicians

Practice addresses (Care Compare)

6550 York Ave S
Suite 112
Edina, MN 55435-2332
Phone (952) 746-1854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10832MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Nov 29, 2010 Accepting new patients
Allina Health System CurrentSince Nov 29, 2010 Accepting new patients

Locations

17599 Kenwood Trl
Lakeville, MN 55044
Phone (952) 985-8200

825 Nicollet Mall
Ste 221
Minneapolis, MN 55402
Phone (612) 339-0807

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

280 Smith Ave N
Ste 600
Saint Paul, MN 55102
Phone (651) 241-6550

360 Sherman St
Ste 160
Saint Paul, MN 55102
Phone (651) 241-7200

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1043512445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 SMITH AVE N",
            "address_2": "SUITE #600",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022424",
            "telephone_number": "651-241-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SMITH AVE N",
            "address_2": "SUITE #600",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022424",
            "telephone_number": "651-241-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "KYAH",
        "middle_name": "FONS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYAH",
            "last_name": "FONS",
            "middle_name": "SUE",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.