Individual provider Active NPI

Kaitlin Zabel

  • Physician Assistant
  • Lakeville, MN
National Provider Identifier
1164215539
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
20520 Keokuk Ave Ste 104
Lakeville, MN 55044-6085
Phone
(952) 469-5033
NPI assigned
May 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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 Primary

Addresses

Primary practice location

20520 Keokuk Ave Ste 104
Lakeville, MN 55044-6085

Mailing address

21625 Boulder Creek Dr
Lakeville, MN 55044-4800

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
I20250807000754 MN Practitioner - Physician Assistant 4981102225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epiphany Dermatology of Minnesota LLCGroup PAC ID 9830196575, 4 clinicians

Practice addresses (Care Compare)

20520 Keokuk Ave
Suite 104
Lakeville, MN 55044-6085
Phone (952) 469-5033

2718 Ekko Ave
Albert Lea, MN 56007-2070
Phone (507) 373-2270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15389MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. 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": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1164215539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21625 BOULDER CREEK DR",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20520 KEOKUK AVE STE 104",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446085",
            "telephone_number": "952-469-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZABEL",
        "first_name": "KAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

Verify at the official NPI Registry.