Individual provider Active NPI

Yehudis Rena Last

  • Student in an Organized Health Care Education/Training Program
  • Crystal, MN
National Provider Identifier
1306558317
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
5700 Bottineau Blvd
Crystal, MN 55429-3183
Phone
(763) 504-6500
NPI assigned
Dec 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

5700 Bottineau Blvd
Crystal, MN 55429-3183

Mailing address

5700 Bottineau Blvd
Crystal, MN 55429-3183
Phone (763) 504-6500

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
I20250603003549 MN Practitioner - Physician Assistant 4284143918 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
Group practices
Northwest Family Physicians PAGroup PAC ID 0042102956, 26 clinicians

Practice addresses (Care Compare)

5700 Bottineau Blvd
Suite 100
Crystal, MN 55429-3184
Phone (763) 504-6500

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1306558317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 BOTTINEAU BLVD",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293183",
            "telephone_number": "763-504-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 BOTTINEAU BLVD",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293183",
            "telephone_number": "763-504-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAST",
        "first_name": "YEHUDIS",
        "middle_name": "RENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal, MN

Sources for this page

Verify at the official NPI Registry.