Individual provider Active NPI

Kelsey Joy Carlson, PA-C

  • Physician Assistant
  • Woodbury, MN
National Provider Identifier
1194538439
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6025 Lake Rd Ste 200
Woodbury, MN 55125-1710
Phone
(651) 999-6800
Fax
(833) 905-0989
NPI assigned
Jan 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 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

6025 Lake Rd Ste 200
Woodbury, MN 55125-1710

Mailing address

3001 Metro Dr Ste 460
Bloomington, MN 55425-1548
Phone (651) 999-6800

Other names 1

  • Kelsey Joy Rothermel Former name

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
I20250228003088 MN Practitioner - Physician Assistant 7315468717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minnesota Urology, PAGroup PAC ID 0840183984, 83 clinicians

Practice addresses (Care Compare)

1185 Town Centre Dr
Eagan, MN 55123-1189
Phone (651) 999-6800

6025 Lake Rd
Suite 200
Woodbury, MN 55125-1710
Phone (651) 999-6800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Urologic Specialists PA PastSince Feb 2, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kelsey.carlson.1@20581.direct.athenahealth.com

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1194538439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 METRO DR STE 460",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251548",
            "telephone_number": "651-999-6800",
            "fax_number": "651-999-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 LAKE RD STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251710",
            "telephone_number": "651-999-6800",
            "fax_number": "833-905-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KELSEY",
        "middle_name": "JOY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "ROTHERMEL",
            "middle_name": "JOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.