Individual provider Active NPI

Kadi Weyandt, PA-C

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1053778191
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12112 Issued in MN
Practice address
407 E 3Rd St
Duluth, MN 55805-1950
Phone
(218) 786-4000
NPI assigned
Jan 20, 2016
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 53956 CA
Physician Assistant 363A00000X 12112 MN Primary

Addresses

Primary practice location

407 E 3Rd St
Duluth, MN 55805-1950

Mailing address

407 E 3Rd St
Duluth, MN 55805-1950
Phone (218) 786-4000

Other practice location 1

2 Embarcadero Ctr Lbby Level
San Francisco, CA 94111-3823
Phone (888) 663-6331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20160310001414 MN Practitioner - Physician Assistant 5698071066 Reassigns benefits to 2 organizations
I20160328002249 WI Practitioner - Physician Assistant 5698071066 Reassigns benefits to 3 organizations
I20171116001960 FL Practitioner - Physician Assistant 5698071066 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53956CAMDProsthodontist
2446MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Essentia Health Virginia, LLC CurrentSince Aug 19, 2022 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Jul 1, 2025 Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
Essentia Health Virginia, LLC CurrentSince Aug 19, 2022 Accepting new patients
Medical Services, Inc CurrentSince Sep 1, 2024 Accepting new patients
St Marys Medical Center CurrentSince Mar 21, 2016 Accepting new patients
St. Mary's Hospital of Superior CurrentSince May 16, 2016 Accepting new patients
St. Mary's Medical Center CurrentSince Mar 21, 2016 Accepting new patients
Medical Services, Inc CurrentSince Sep 1, 2024 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
Essentia Health Virginia, LLC Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443

407 E 3rd St
Duluth, MN 55805
Phone (218) 786-4357

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

11040 N State Road 77
Hayward, WI 54843
Phone (715) 934-4244

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1053778191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051950",
            "telephone_number": "218-786-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051950",
            "telephone_number": "218-786-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Embarcadero Ctr Lbby Level",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941113823",
            "country_code": "US",
            "telephone_number": "888-663-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEYANDT",
        "first_name": "KADI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53956",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.