Individual provider Active NPI

Karissa Joy Klaers

  • Counselor
  • Osseo, MN
National Provider Identifier
1245871235
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
411 3Rd St SE
Osseo, MN 55369-1606
Phone
(763) 259-8086
NPI assigned
Oct 1, 2019
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

411 3Rd St SE
Osseo, MN 55369-1606

Mailing address

16023 62ND St NE
Otsego, MN 55330-6423
Phone (763) 259-8086

Other identifiers 1

IdentifierTypeStateIssuer
T650275605011OtherMNDRIVER'S LICENSE

Other names 1

  • Karissa Joy Tawfeek Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 18, 2025 through Mar 18, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4367MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Karis Health, PLLC Single Specialty CurrentSince Mar 20, 2025 Accepting new patients
Beacon Therapy Associates, PC Single Specialty PastSince Oct 1, 2019 Accepting new patients

Locations

411 3rd St SE
Osseo, MN 55369
Phone (763) 259-8086

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1245871235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16023 62ND ST NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553306423",
            "telephone_number": "763-259-8086",
            "fax_number": "763-259-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 3RD ST SE",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "553691606",
            "telephone_number": "763-259-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAERS",
        "first_name": "KARISSA",
        "middle_name": "JOY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "T650275605011",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARISSA",
            "last_name": "TAWFEEK",
            "middle_name": "JOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Osseo, MN

Sources for this page

Verify at the official NPI Registry.