Katelyn Corine Krueger, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

20819 Highway 23 NE
New London, MN 56273-9402

Phone

(320) 760-5675

NPI assigned

Jun 4, 2021

Last updated

Jun 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Katelyn Corine Lundblad Former name

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Glacial Ridge Hospital DistrictGroup PAC ID 5294789194, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glacial Ridge Hospital Hospital, Glenwood, MN, CCN 241376

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c

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.

• Glacial Ridge Hospital District

  dba Brooten Medical Center

  • Family Medicine Physician
  • Brooten, MN
  • NPI 1255348223
  Medicare reassignment Care Compare group
• Clarus Dermatology PA

  dba Clarus Dermatology

  • MOHS-Micrographic Surgery Physician
  • New Brighton, MN
  • NPI 1740532340
  Medicare reassignment
• Glacial Ridge Hospital District

  dba Starbuck Medical Center

  • Rural Health Clinic/Center
  • Starbuck, MN
  • NPI 1063952026
  NPD
• Glacial Ridge Hospital District

  dba Glenwood Family Eye Center

  • Optometrist
  • Glenwood, MN
  • NPI 1306206446
  NPD
• Glacial Ridge Hospital District

  • Critical Access Hospital
  • Glenwood, MN
  • NPI 1538178520
  NPD
• Glacial Ridge Hospital District

  dba Glacial Ridge Homecare

  • Home Health Agency
  • Glenwood, MN
  • NPI 1922017052
  NPD (past)

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

• Glacial Ridge Hospital District

  • Critical Access Hospital
  • Glenwood, MN
  • NPI 1538178520
  Care Compare affiliation

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1104493568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20819 HIGHWAY 23 NE",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "562739402",
            "telephone_number": "320-760-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20819 HIGHWAY 23 NE",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "562739402",
            "telephone_number": "320-760-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "KATELYN",
        "middle_name": "CORINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "LUNDBLAD",
            "middle_name": "CORINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Candace Jo Eck, LAC
• Fischer Laser Eye Center, LLC (Family Eye Center)
• Nicholas Goelz
• Independent School District 345
• Krupke Chiropractic PLLC
• Brett Nathan Krupke, D.C.
• Kwo 5 Star, Inc (Lake Region Home Health)
• Living Services Foundation New London LLC (Glenoaks Adult Daycare Services)
• Living Services Foundation/ New London LLC (Lake Region Home Health)

• Physician Assistant in New London, MN
• Providers in New London, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.