NPIMap

Individual provider Active NPI

Kelsey Marie Henningson-Kaye, PA-C

  • Medical Physician Assistant
  • Ortonville, MN
National Provider Identifier
1093976540
Registry record updated Aug 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10580 Issued in MN
Practice address
450 Eastvold Ave
Ortonville Area Health Services/Northside Medical Clini
Ortonville, MN 56278-1252
Phone
(320) 839-6157
Fax
(320) 839-3851
NPI assigned
Jun 18, 2008
Last updated
Aug 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10580 MN Primary
Medical Physician Assistant 363AM0700X 2260-023 WI

Addresses

Primary practice location

450 Eastvold Ave
Ortonville Area Health Services/Northside Medical Clini
Ortonville, MN 56278-1252

Mailing address

450 Eastvold Ave
Ortonville Area Health Services/Northside Medical Clini
Ortonville, MN 56278
Phone (320) 839-6157

Other names 1

  • Ms. Kelsey Marie Henningson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091006000503 MN Practitioner - Physician Assistant 4486727237 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortonville Area Health ServicesGroup PAC ID 2365448768, 12 clinicians

Practice addresses (Care Compare)

450 Eastvold Ave
Ortonville, MN 56278-1252
Phone (320) 839-6157

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.21 of 100Reported as group
Quality
92.56
Promoting interoperability
100
Improvement activities
40
Cost
41.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10580MNMDMedical Physician Assistant
2260-023WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ortonville Area Health Services CurrentSince Mar 14, 2012 Accepting new patients
Ortonville Area Health Services CurrentSince Mar 14, 2012 Accepting new patients
Ortonville Area Health Services Past Accepting new patients
Ortonville Area Health Services Past Accepting new patients

Locations

450 Eastvold Ave
Ortonville, MN 56278
Phone (320) 839-2502

Organizations & group practices 5

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 6

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": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754092800000",
    "number": "1093976540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 EASTVOLD AVE",
            "address_2": "ORTONVILLE AREA HEALTH SERVICES/NORTHSIDE MEDICAL CLINI",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "56278",
            "telephone_number": "320-839-6157",
            "fax_number": "320-839-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 EASTVOLD AVE",
            "address_2": "ORTONVILLE AREA HEALTH SERVICES/NORTHSIDE MEDICAL CLINI",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562781252",
            "telephone_number": "320-839-6157",
            "fax_number": "320-839-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNINGSON-KAYE",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2025-08-02",
        "certification_date": "2025-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "10580",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "2260-023",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "HENNINGSON",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ortonville, MN

Sources for this page

Verify at the official NPI Registry.