NPIMap

Individual provider Active NPI

Konstantin V. Shatskikh, PA-C

  • Physician Assistant
  • Owatonna, MN
National Provider Identifier
1346435740
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10312 Issued in MN
Practice address
2200 NW 26TH St
Owatonna, MN 55060
Phone
(504) 451-1120
NPI assigned
Sep 9, 2007
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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 10312 MN Primary

Addresses

Primary practice location

2200 NW 26TH St
Owatonna, MN 55060

Mailing address

2200 NW 26TH St
Owatonna, MN 55060-5503
Phone (504) 451-1120

Other practice location 1

810 County Road 42 W
Burnsville, MN 55337
Phone (815) 363-9500

Other practice location 2

810 County Road 42 W
Burnsville, MN 55337
Phone (815) 363-9500

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
I20081219000043 MN Practitioner - Physician Assistant 7719049147 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Martin Luther King Dr
Jr
Mankato, MN 56001-6460
Phone (507) 385-6500

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10312MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Dec 14, 2025 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 1, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jan 1, 2022 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jan 1, 2022 Accepting new patients
Group Health, Inc. CurrentSince Apr 2, 2013 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 1, 2017 Accepting new patients
Group Health, Inc. CurrentSince Apr 2, 2013 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Past Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Past Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431

2200 NW 26th St
Owatonna, MN 55060
Phone (507) 451-1120

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: kshatskikh87509@ehrdirect.mayoclinicmsg.org

Organizations & group practices 11

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1189296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1346435740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 NW 26TH ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550605503",
            "telephone_number": "504-451-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NW 26TH ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "55060",
            "telephone_number": "504-451-1120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 County Road 42 W",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "55337",
            "country_code": "US",
            "telephone_number": "815-363-9500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 County Road 42 W",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "55337",
            "country_code": "US",
            "telephone_number": "815-363-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHATSKIKH",
        "first_name": "KONSTANTIN",
        "middle_name": "V.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-09",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owatonna, MN

Sources for this page

Verify at the official NPI Registry.