NPIMap

Individual provider Active NPI

Kathleen Conner, PA-C

  • Medical Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1295246114
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
12595 Issued in MN
Practice address
2800 Chicago Avenue South
Ste 300
Minneapolis, MN 55407
Phone
(651) 225-7855
Fax
(651) 312-1570
NPI assigned
Oct 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 12595 MN Primary

Addresses

Primary practice location

2800 Chicago Avenue South
Ste 300
Minneapolis, MN 55407

Mailing address

3433 Broadway St NE Ste 115
Minneapolis, MN 55413-1759
Phone (651) 312-1505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180103002046 MN Practitioner - Physician Assistant 4385902949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Oncology Hematology PAGroup PAC ID 6709799752, 131 clinicians

Practice addresses (Care Compare)

10150 Niagara LN N
Suite 100
Maple Grove, MN 55369-7588
Phone (844) 317-4673

6545 France Ave S
Suite 210
Edina, MN 55435-2281
Phone (952) 928-2900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.19 of 100Reported as apm
Quality
72.34
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12595MNMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince May 1, 2020 Accepting new patients
Minnesota Oncology Hematology PA Medical CurrentSince May 16, 2022 Accepting new patients
Minnesota Oncology Hematology PA CurrentSince May 16, 2022 Accepting new patients
Infinite Health Collaborative, PA CurrentSince May 1, 2020 Accepting new patients
Minnesota Oncology Hematology, PA Medical Past Accepting new patients
Minnesota Oncology Hematology, PA Medical Past Accepting new patients
Minnesota Oncology Hematology PA Medical PastSince Jan 14, 2024 Accepting new patients
Pelvic Floor Center, LLC Past Accepting new patients
Minnesota Oncology Hematology, PA PastSince Jan 12, 2020 Accepting new patients

Locations

675 E Nicollet Blvd
Ste 100
Burnsville, MN 55337
Phone (952) 435-8516

110105 Pioneer Trl W
Ste 302
Chaska, MN 55318
Phone (952) 361-5800

10150 Niagara Ln N
#100
Maple Grove, MN 55369
Phone (763) 220-1316

910 E 26th St
Ste 100200
Minneapolis, MN 55404
Phone (612) 884-6300

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

11850 Blackfoot St NW
Ste 100
Minneapolis, MN 55433
Phone (763) 712-2100

480 Osborne Rd NE
Ste 220
Minneapolis, MN 55432
Phone (763) 786-1620

6545 France Ave S
Ste 210
Minneapolis, MN 55435
Phone (952) 928-2900

2800 Chicago Ave
Ste 300
Minneapolis, MN 55407
Phone (651) 225-7800

2805 Campus Dr
Ste 105
Plymouth, MN 55441
Phone (763) 519-7440

2550 University Ave W
Ste 110N
Saint Paul, MN 55114
Phone (651) 602-5309

310 Smith Ave N
Ste 100
Saint Paul, MN 55102
Phone (651) 251-5500

1983 Sloan Pl
Ste 7
Saint Paul, MN 55117
Phone (651) 312-1620

1580 Beam Ave
Saint Paul, MN 55109
Phone (651) 255-8480

560 S Maple St
Ste 100
Waconia, MN 55387
Phone (952) 442-6006

6025 Lake Rd
Ste 110
Woodbury, MN 55125
Phone (651) 735-7414

Interoperability endpoints

  • Direct secure messaging: katie.conner@moh.ikm.direct-ci.com

Organizations & group practices 9

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1295246114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE STE 115",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131759",
            "telephone_number": "651-312-1505",
            "fax_number": "612-248-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CHICAGO AVENUE SOUTH",
            "address_2": "STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55407",
            "telephone_number": "651-225-7855",
            "fax_number": "651-312-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "12595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.