Noelle Anne Kreofsky, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12408 Issued in MN

Practice address

5255 Members Pkwy NW
Rochester, MN 55901-8381

Phone

(507) 218-3701

Fax

(507) 258-5503

NPI assigned

Jul 6, 2017

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Croix Psychiatric LLCGroup PAC ID 9335288786, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• St. Croix Psychiatric, LLC

  dba PrairieCare Medical Group

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1881849586
  Medicare reassignment Care Compare group
• Prairiecare LLC

  dba PrairieCare

  • Psychiatric Hospital
  • Brooklyn Park, MN
  • NPI 1215182928
  NPD (past)
• Zumbro Valley Health Center

  • Community/Behavioral Health Agency
  • Rochester, MN
  • NPI 1801961263
  NPD (past)

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1073034450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 MEMBERS PKWY NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559018381",
            "telephone_number": "907-720-9108",
            "fax_number": "507-218-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 MEMBERS PKWY NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559018381",
            "telephone_number": "507-218-3701",
            "fax_number": "507-258-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREOFSKY",
        "first_name": "NOELLE",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Richard Kreitz, MD
• Amy L Krekelberg, OT
• Tammy M Kremers, RN, CNP
• Caitlin Krenz, LPCC
• Kyle Krenzke, PHARMD
• Justin Kreps, SRNA
• Steven Kreul, DC
• Wade W Kreun, CRNA
• Justin David Kreuter, M.D.
• Carrie Ann Krieger, PHARM.D.

• Physician Assistant in Rochester, MN
• Providers in Rochester, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.