Individual provider Active NPI

Kimberly Ann Plessel, MS, RD, LD

  • Registered Dietitian
  • Crystal, MN
National Provider Identifier
1124377825
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2423 Issued in MN
Practice address
5700 Bottineau Blvd
Suite 210
Crystal, MN 55429-3183
Phone
(651) 335-6552
NPI assigned
Sep 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2423 MN Primary

Addresses

Primary practice location

5700 Bottineau Blvd
Suite 210
Crystal, MN 55429-3183

Mailing address

5700 Bottineau Blvd
Suite 210
Crystal, MN 55429-3183
Phone (651) 335-6552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131204002187 MN Practitioner - Registered Dietitian Or Nutrition Professional 3476789066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
University of Minnesota Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier OBGYN of Minnesota PLLCGroup PAC ID 1355396110, 88 clinicians

Practice addresses (Care Compare)

9825 Hospital Dr
Suite 205
Maple Grove, MN 55369-4480
Phone (763) 587-7000

Merit-based Incentive Payment System (MIPS)

Final score
87.24 of 100Reported as group
Quality
86.35
Promoting interoperability
100
Improvement activities
40
Cost
71.1

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2423MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Obstetrics & Gynecology Past Accepting new patients

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": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1124377825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 BOTTINEAU BLVD",
            "address_2": "SUITE 210",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293183",
            "telephone_number": "651-335-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 BOTTINEAU BLVD",
            "address_2": "SUITE 210",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293183",
            "telephone_number": "651-335-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLESSEL",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "2423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.