Individual provider Active NPI

Isabel Mae Kobylinski, DNP, CNP, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1063096667
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
8450 Issued in MN
Practice address
1700 University Ave W
Saint Paul, MN 55104-3727
Phone
(651) 232-2002
Fax
(651) 326-9635
NPI assigned
May 10, 2021
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 8450 MN Primary
Registered Nurse 163W00000X 2460379 MN

Addresses

Primary practice location

1700 University Ave W
Saint Paul, MN 55104-3727

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (651) 232-2002

Other names 1

  • Isabel Mae Rizor Former 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
I20211011001299 MN Practitioner - Nurse Practitioner 6002214780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

13810 Community Dr
Burnsville, MN 55337-4593
Phone (952) 435-8116

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2460379MNMDRegistered Nurse
8450MNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Oct 22, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Oct 22, 2021 Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Interoperability endpoints

  • Direct secure messaging: ikobylinski487781@fairview.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1063096667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "651-232-2002",
            "fax_number": "651-236-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "651-232-2002",
            "fax_number": "651-326-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBYLINSKI",
        "first_name": "ISABEL",
        "middle_name": "MAE",
        "credential": "DNP, CNP, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "8450",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2460379",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ISABEL",
            "last_name": "RIZOR",
            "middle_name": "MAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.