Individual provider Active NPI

Kaylee Lynn Monberg, PA

  • Medical Physician Assistant
  • Edina, MN
National Provider Identifier
1104208768
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
6401 France Ave S
Edina, MN 55435-2104
Phone
(319) 310-8641
NPI assigned
Jun 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

6401 France Ave S
Edina, MN 55435-2104

Mailing address

6401 France Ave S
Edina, MN 55435-2104

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
I20150921002482 MN Practitioner - Physician Assistant 7012224207 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

14101 Fairview Dr
Burnsville, MN 55337-2537

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-1313

919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344

Hospital & facility affiliations

  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11880MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Sep 8, 2015 Accepting new patients
Healtheast Medical Research Institute CurrentSince Mar 3, 2020 Accepting new patients
Fairview Health Services CurrentSince Sep 8, 2015 Accepting new patients
Fairview Clinics CurrentSince Mar 3, 2020 Accepting new patients
Fairview Clinics CurrentSince Mar 3, 2020 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

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

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: kmonberg346771@fairview.direct-ci.com

Organizations & group practices 9

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 3

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": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1104208768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352104",
            "telephone_number": "319-310-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONBERG",
        "first_name": "KAYLEE",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.