Individual provider Active NPI

Kendra Anastasia Pallin, MS, MHS, PA-C

  • Physician Assistant
  • Waconia, MN
National Provider Identifier
1114868627
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15593 Issued in MN
Practice address
875 E Main St
Waconia, MN 55387-1081
Phone
(952) 442-9334
NPI assigned
Apr 1, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15593 MN Primary

Addresses

Primary practice location

875 E Main St
Waconia, MN 55387-1081

Mailing address

875 E Main St
Waconia, MN 55387-1081

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
I20260506001838 MN Practitioner - Physician Assistant 0042788259 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Primary Care Minnesota PLLCGroup PAC ID 2163945460, 30 clinicians
Minuteclinic Diagnostic of Minnesota PAGroup PAC ID 7810289949, 83 clinicians

Practice addresses (Care Compare)

1010 W Lake St
Minneapolis, MN 55408-2883
Phone (866) 389-2727

15051 Galaxie Ave
Apple Valley, MN 55124-6987
Phone (866) 389-2727

875 E Main St
Waconia, MN 55387-1081
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
15593MNMDPhysician Assistant

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1775001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1114868627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 E MAIN ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 E MAIN ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871081",
            "telephone_number": "952-442-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLIN",
        "first_name": "KENDRA",
        "middle_name": "ANASTASIA",
        "credential": "MS, MHS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-01",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.