Kathleen Dynan

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11189 Issued in MN

Practice address

1997 Sloan PL Ste 17
Maplewood, MN 55117-2051

Phone

(651) 772-6251

NPI assigned

Jan 19, 2024

Last updated

Jan 19, 2024By the provider in NPPES

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

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Nephrology Consultants PAGroup PAC ID 7214004068, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview St John's Hospital Hospital, Maplewood, MN, CCN 240210

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/3y297hHso-SAgtaVMIScpv67gSH7SYy3/
• Direct secure messaging: kdynan44893@direct.davitaphysiciansolutions.com

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.

• Associated Nephrology Consultants, P.a.

  • Nephrology Physician
  • Maplewood, MN
  • NPI 1104976158
  Medicare reassignment Care Compare group NPD
• Healtheast Medical Research Institute

  dba HealthEast Vadnais Heights Clinic

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment NPD
• Healtheast Medical Research Institute

  dba HealthEast Professional Services

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1508191552
  NPD
• Healtheast Medical Research Institute

  • Family Medicine Physician
  • Maplewood, MN
  • NPI 1710147954
  NPD

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

• Healtheast St. John's Hospital

  dba Fairview St John's Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482
  Care Compare affiliation

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1083475776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1997 SLOAN PL STE 17",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551172051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1997 SLOAN PL STE 17",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551172051",
            "telephone_number": "651-772-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYNAN",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "11189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Dukowitz, RPH
• Sekou Dukuly
• Megan Dutton, DNP
• Paul Robert Duxbury, PT
• Dynamic Connections, Inc.
• Gregory Eugene Eastlund, D.C.
• Thomas Ebert, DPT
• Ecumen
• Ecumen (Ecumen Seasons at Maplewood)
• Sahar Edalatpour, DDS

• Nurse Practitioner in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.