Kristin K Mellgren, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9855 Issued in MN

Practice address

161 19TH St S Ste 106
Sartell, MN 56377-2555

Phone

(320) 252-3376

Fax

(320) 288-2701

NPI assigned

Jul 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Small Holdings PAGroup PAC ID 4981133238, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Small Holdings PA

  • Dermatology Physician
  • Sartell, MN
  • NPI 1245052554
  Medicare reassignment Care Compare group
• Lakewood Health System

  • Rural Health Clinic/Center
  • Staples, MN
  • NPI 1841280823
  Medicare reassignment
• Lakewood Health System

  • Community/Retail Pharmacy
  • Pillager, MN
  • NPI 1396519906
  NPD
• Lakewood Health System

  • Clinic/Center
  • Sartell, MN
  • NPI 1669759866
  NPD

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1316976236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 19TH ST S STE 106",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772555",
            "telephone_number": "320-252-3376",
            "fax_number": "320-288-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 19TH ST S STE 106",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772555",
            "telephone_number": "320-252-3376",
            "fax_number": "320-288-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLGREN",
        "first_name": "KRISTIN",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "970001852",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsie Meemken
• Carson James Mehling
• Craig Meiers
• Paul Meirick, M.D.
• Anna Katherine Melicher
• Mend Recovery Services LLC
• Nicole R Mercer Bolton, M.D.
• Barbara Ann Mergen, CNP
• Bobbie Jean Mertens, RN
• Brooke Metteer

• Physician Assistant in Sartell, MN
• Providers in Sartell, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.