Individual provider Active NPI

Kiley Teresa Jo Kleve, PA-C

  • Physician Assistant
  • Saint Cloud, MN
National Provider Identifier
1235716598
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13886 Issued in MN
Practice address
1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone
(320) 656-7024
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 13886 MN Primary

Addresses

Primary practice location

1406 6TH Ave N
Saint Cloud, MN 56303-1900

Mailing address

800 Medical Center Dr
Fairmont, MN 56031-4575
Phone (507) 238-8100

Other practice location 1

101 S Front St Ste 1
Chamberlain, SD 57325-1619
Phone (605) 234-6584

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kreecy653996@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210526003409 SD Practitioner - Physician Assistant 4587063326 Reassigns benefits to 3 organizations
I20211116002584 MN Practitioner - Physician Assistant 4587063326 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Practice addresses (Care Compare)

110 2ND St S
Suite 104
Waite Park, MN 56387-1367
Phone (320) 259-9375

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1302SDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Cloud Hospital CurrentSince Oct 1, 2022 Accepting new patients
Rural Health Care, Inc CurrentSince May 3, 2021 Accepting new patients
Avera McKennan CurrentSince May 3, 2021 Accepting new patients
City of Brookings Current Accepting new patients
St. Cloud Hospital CurrentSince Oct 1, 2022 Accepting new patients
City of Brookings CurrentSince Aug 27, 2021 Accepting new patients
City of Brookings CurrentSince Aug 27, 2021 Accepting new patients
Avera McKennan CurrentSince May 3, 2021 Accepting new patients
Avera McKennan Past Accepting new patients

Locations

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

400 22nd Ave
Brookings, SD 57006
Phone (605) 692-6236

300 22nd Ave
Brookings, SD 57006
Phone (605) 692-6351

101 S Front St
Chamberlain, SD 57325
Phone (605) 234-6584

101 S Front St
Ste 1
Chamberlain, SD 57325
Phone (605) 234-6584

Interoperability endpoints

  • Direct secure messaging: kreecy653996@direct.centracare.com

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1235716598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314575",
            "telephone_number": "507-238-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-656-7024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 S Front St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Chamberlain",
            "state": "SD",
            "postal_code": "573251619",
            "country_code": "US",
            "telephone_number": "605-234-6584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEVE",
        "first_name": "KILEY",
        "middle_name": "TERESA JO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kreecy653996@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kreecy653996@direct.centracare.com",
            "address_1": "1406 6th Ave N",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563031900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.