NPIMap

Individual provider Active NPI

Kimberley Mullin, PA-C

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1124437108
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2138 Issued in MN
Practice address
1021 Bandana Blvd E
Suite 100
Saint Paul, MN 55108-5113
Phone
(651) 241-9700
Fax
(651) 241-3681
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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 2138 MN Primary

Addresses

Primary practice location

1021 Bandana Blvd E
Suite 100
Saint Paul, MN 55108-5113

Mailing address

1021 Bandana Blvd E
Suite 100
Saint Paul, MN 55108-5113
Phone (651) 241-9700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmullin211975@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141008001907 MN Practitioner - Physician Assistant 5991925257 Reassigns benefits to 3 organizations
I20171115000780 WI Practitioner - Physician Assistant 5991925257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

225 Smith Ave N
3Rd FL
St Paul, MN 55102-2383
Phone (612) 775-6200

310 Smith Ave N
Suite 300
St Paul, MN 55102-2383
Phone (952) 946-9777

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Regional Medical Center CurrentSince Sep 30, 2023 Accepting new patients
Allina Health System CurrentSince Aug 4, 2014 Accepting new patients
Allina Health System CurrentSince Aug 4, 2014 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Nov 4, 2017 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

310 Smith Ave N
Ste 330
Saint Paul, MN 55102
Phone (651) 227-6351

225 Smith Ave N
Ste 500
Saint Paul, MN 55102
Phone (651) 292-0616

310 Smith Ave N
Ste 300
Saint Paul, MN 55102
Phone (651) 241-5111

1021 Bandana Blvd E
Ste 100
Saint Paul, MN 55108
Phone (877) 414-2533

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

Interoperability endpoints

  • Direct secure messaging: kmullin211975@excellian.direct.allina.com

Organizations & group practices 8

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 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1124437108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 BANDANA BLVD E",
            "address_2": "SUITE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085113",
            "telephone_number": "651-241-9700",
            "fax_number": "651-241-3681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 BANDANA BLVD E",
            "address_2": "SUITE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085113",
            "telephone_number": "651-241-9700",
            "fax_number": "651-241-3681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "KIMBERLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "2138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmullin211975@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1021 Bandana Blvd E",
            "address_2": "Suite 100",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551085113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.