NPIMap

Individual provider Active NPI

Katrina Rebecca Rogahn, PA-C

  • Medical Physician Assistant
  • Elbow Lake, MN
National Provider Identifier
1386082709
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
11375 Issued in MN
Practice address
1411 State Highway 79 East
Elbow Lake, MN 56531-4611
Phone
(218) 685-4461
Fax
(218) 685-6749
NPI assigned
Jun 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 11375 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1411 State Highway 79 East
Elbow Lake, MN 56531-4611

Mailing address

1411 State Highway 79E
Elbow Lake, MN 56531
Phone (218) 685-4461

Other identifiers 1

IdentifierTypeStateIssuer
A341055895108OtherMNDRIVERS LICENSE

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
I20130916000771 MN Practitioner - Physician Assistant 6204070147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1411 Hwy 79 E
Elbow Lake, MN 56531-4645
Phone (218) 685-7300

24 E 7TH St
Morris, MN 56267-1312
Phone (320) 589-4008

649 /2 State St NW
Evansville, MN 56326-8124
Phone (218) 948-2040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.33 of 100Reported as group
Quality
93.68
Promoting interoperability
100
Improvement activities
40
Cost
70.75

Merit-based Incentive Payment System (MIPS)

Final score
88.64 of 100Reported as group
Quality
86.84
Promoting interoperability
100
Improvement activities
40
Cost
75.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11375MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation CurrentSince Jul 26, 2013 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Mar 9, 2014 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jul 26, 2013 Accepting new patients
Lake Region Healthcare Corporation Past Accepting new patients
West Central Internal Medicine Past Accepting new patients

Locations

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537

2311 W Lincoln Ave
Fergus Falls, MN 56537
Phone (218) 739-6800

Organizations & group practices 5

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 4

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": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1386082709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 STATE HIGHWAY 79E",
            "city": "ELBOW LAKE",
            "state": "MN",
            "postal_code": "56531",
            "telephone_number": "218-685-4461",
            "fax_number": "218-685-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 STATE HIGHWAY 79 EAST",
            "city": "ELBOW LAKE",
            "state": "MN",
            "postal_code": "565314611",
            "telephone_number": "218-685-4461",
            "fax_number": "218-685-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGAHN",
        "first_name": "KATRINA",
        "middle_name": "REBECCA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "11375",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "A341055895108",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elbow Lake, MN

Sources for this page

Verify at the official NPI Registry.