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Individual provider Active NPI

Kara Renee Zachman Ferris, PA-C

  • Physician Assistant
  • Roseville, MN
National Provider Identifier
1336495928
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1776 Issued in MN
Practice address
2355 Highway 36 W Ste 100
Roseville, MN 55113-3905
Phone
(651) 292-0000
Fax
(651) 292-2178
NPI assigned
Aug 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1776 MN Primary

Addresses

Primary practice location

2355 Highway 36 W Ste 100
Roseville, MN 55113-3905

Mailing address

2355 Highway 36 W Ste 100
Roseville, MN 55113-3905
Phone (651) 292-0000

Other practice location 1

166 4th St E
Saint Paul, MN 55101-1421
Phone (651) 292-2000

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
I20121127000569 MN Practitioner - Physician Assistant 0648421511 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Radiology PAGroup PAC ID 4486568482, 217 clinicians

Practice addresses (Care Compare)

1175 Nininger Rd
Hastings, MN 55033-1056
Phone (651) 292-2000

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 292-2000

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 292-2000

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (651) 292-2000

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 292-2000

6401 France Ave S
Edina, MN 55435-2104
Phone (651) 292-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.17 of 100Reported as group
Quality
95
Improvement activities
40
Cost
82.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1776MNMDMarriage & Family Therapist
11219MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince May 1, 2021 Accepting new patients
Lac Qui Parle Clinic of Madison Inc Current Accepting new patients
Fairview Express Care CurrentSince May 1, 2021 Accepting new patients
Consulting Radiologists, LTD Past Accepting new patients

Locations

820 3rd Ave
Madison, MN 56256
Phone (320) 598-3552

900 2nd Ave
Madison, MN 56256
Phone (320) 598-7536

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

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

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1336495928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-0000",
            "fax_number": "651-292-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-0000",
            "fax_number": "651-292-2178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 4th St E",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551011421",
            "country_code": "US",
            "telephone_number": "651-292-2000",
            "fax_number": "651-292-2178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERRIS",
        "first_name": "KARA",
        "middle_name": "RENEE ZACHMAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-01",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.