Individual provider Active NPI

Kyle Alan Cassidy-Wescott, MD

  • Family Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1073004222
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
77850 Issued in MN
Practice address
205 Wabasha St S
Saint Paul, MN 55107-1805
Phone
(952) 853-8800
NPI assigned
May 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-48731 IA
Family Medicine Physician 207Q00000X 77850 MN Primary
Family Medicine Physician 207Q00000X 036167181 IL

Addresses

Primary practice location

205 Wabasha St S
Saint Paul, MN 55107-1805

Mailing address

611 W Park St
Fapc
Urbana, IL 61801-2500

Other practice location 1

1701 Curtis Rd
Champaign, IL 61822-9678
Phone (217) 365-6203

Other practice location 2

411 10th St SE
Cedar Rapids, IA 52403-2442
Phone (319) 363-3600

Other practice location 3

1765 Lininger Ln
North Liberty, IA 52317-2335
Phone (319) 467-7888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240326003043 IL Practitioner - Family Practice 2860748076 Reassigns benefits to 2 organizations
I20240821001479 MN Practitioner - Family Practice 2860748076 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mankato Clinic LTDGroup PAC ID 5597677955, 243 clinicians
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

1230 Main St E
PO Box 8674
Mankato, MN 56002-8674
Phone (507) 625-1811

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

  • Mayo Clinic Health System - Mankato Hospital, Mankato, MN, CCN 240093

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-48731IAMDFamily Medicine Physician
77850MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoopeston Community Memorial Hospital CurrentSince Feb 12, 2024 Accepting new patients
Carle Health Care Incorporated Family Medicine CurrentSince Feb 12, 2024 Accepting new patients
Hoopeston Community Memorial Hospital Family Medicine CurrentSince Feb 12, 2024 Accepting new patients
Mankato Clinic LTD Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients

Locations

1701 Curtis Rd
Champaign, IL 61822
Phone (217) 365-6201

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

1230 E Main St
Mankato, MN 56001
Phone (507) 389-8502

Interoperability endpoints

  • Direct secure messaging: kcassidywescottmd390041@carlehiedirect.net
  • Direct secure messaging: kylecassidy-wescott@mklt.allscriptsdirect.net
  • Direct secure messaging: kcassidywescott184189@uihcdirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1073004222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WABASHA ST S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551071805",
            "telephone_number": "952-853-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618229678",
            "country_code": "US",
            "telephone_number": "217-365-6203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 10th St SE",
            "address_purpose": "LOCATION",
            "city": "Cedar Rapids",
            "state": "IA",
            "postal_code": "524032442",
            "country_code": "US",
            "telephone_number": "319-363-3600",
            "fax_number": "319-363-9971",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1765 Lininger Ln",
            "address_purpose": "LOCATION",
            "city": "North Liberty",
            "state": "IA",
            "postal_code": "523172335",
            "country_code": "US",
            "telephone_number": "319-467-7888",
            "fax_number": "319-467-7399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASSIDY-WESCOTT",
        "first_name": "KYLE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD-48731",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "77850",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036167181",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.