Kelsey Kathleen Strub

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2720 Fairview Ave N Ste 200
Roseville, MN 55113-1306

Phone

(952) 452-6503

NPI assigned

Apr 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Tareen Dermatology PAGroup PAC ID 8123288156, 45 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: kfiedler@tareenderm.emadirect.md

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.

• Tareen Dermatology, P.a.

  • Dermatology Physician
  • Roseville, MN
  • NPI 1063782621
  Medicare reassignment Care Compare group
• Tareen Dermatology, PA

  • Non-Pharmacy Dispensing Site
  • Maplewood, MN
  • NPI 1851856504
  NPD (past)

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1124648795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 FAIRVIEW AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 FAIRVIEW AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131306",
            "telephone_number": "952-452-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUB",
        "first_name": "KELSEY",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2022-01-21",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karin Leigh Stoutenburg, D.C.
• Straight Smiles, PLLC
• Kendall Strand, M.D.
• Beverly Stratton, MA, THD
• Tracey Lue Stretch, BC-HIS
• Sarah Studley
• Jean Stumpf
• Hana Subasic-Sullivan, MA,LMFT
• Suburban Imaging, LLC
• Suburban Radiologic Consultants, LTD.

• Physician Assistant in Roseville, MN
• Providers in Roseville, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.