Mark Kassebaum, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

33240 Issued in MN

Practice address

1013 Hart Blvd
Monticello, MN 55362-8575

Phone

(612) 670-0610

NPI assigned

Oct 10, 2006

Last updated

Mar 27, 2019By the provider in NPPES

Sex

Male

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

University of Iowa, RJ & L Carver College of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regional Anesthesia Services PAGroup PAC ID 0648250548, 12 clinicians

Centracare Health System-NR LLCGroup PAC ID 3870739410, shared by 4 NPIs, 63 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alomere Health Hospital, Alexandria, MN, CCN 240030
• Centracare Health - Monticello Hospital, Monticello, MN, CCN 241362

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkassebaum418736@direct.centracare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Regional Anesthesia Services PA

  • Anesthesiology Physician
  • Minnetonka, MN
  • NPI 1073621850
  Medicare reassignment Care Compare group NPD
• Centracare Health System-NR LLC

  dba CentraCare Health - Monticello Hospital

  • Critical Access Hospital
  • Monticello, MN
  • NPI 1275872772
  Medicare reassignment NPD
• Centracare Health System-NR LLC

  dba CentraCare - Monticello Specialty Clinic

  • Multi-Specialty Clinic/Center
  • Monticello, MN
  • NPI 1558600874
  Medicare reassignment NPD
• Centracare Health System-NR LLC

  dba Geriatric Behavioral Health

  • Psychiatric Hospital Unit
  • Monticello, MN
  • NPI 1003353202
  NPD

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

• Alomere Health

  • General Acute Care Hospital
  • Alexandria, MN
  • NPI 1558236091
  Care Compare affiliation
• Centracare Health System-NR LLC

  dba CentraCare Health - Monticello Hospital

  • Critical Access Hospital
  • Monticello, MN
  • NPI 1275872772
  Care Compare affiliation
• Centracare Health System-NR LLC

  dba CentraCare - Monticello Specialty Clinic

  • Multi-Specialty Clinic/Center
  • Monticello, MN
  • NPI 1558600874

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1205924776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 HART BLVD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628575",
            "telephone_number": "612-670-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 HART BLVD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628575",
            "telephone_number": "612-670-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSEBAUM",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "33240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Jones
• Matthias Joseph Jordan, M.D.
• JRL Consulting LLC
• Kyle Jussila
• Christopher Kaplan
• Kelsey Marie Keil, MSW, LICSW
• Ralph Kiffmeyer, CRNA
• Kindred Family Services
• Kelsey J King, APRN, CNP
• Elle Auna Kirkendall

• Anesthesiology Physician in Monticello, MN
• Providers in Monticello, MN by specialty
• Anesthesiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.