Active NPI
Karen J Lesetmoe, PA
- Medical Physician Assistant
- Crookston, MN
National Provider Identifier
1417033507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 9483
- Practice address
- 323 S Minnesota St
Crookston, MN 56716-1601 - Phone
- (800) 746-6551
- NPI assigned
- Oct 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 9483 | MN | Primary |
Addresses
Primary practice location
323 S Minnesota St
Crookston, MN 56716-1601
Mailing address
16149 N Trinity Point Rd SE
Mentor, MN 56736-9493
Phone (218) 687-4144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9483 | MN | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417033507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16149 N TRINITY POINT RD SE",
"city": "MENTOR",
"state": "MN",
"postal_code": "567369493",
"telephone_number": "218-687-4144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "323 S MINNESOTA ST",
"city": "CROOKSTON",
"state": "MN",
"postal_code": "567161601",
"telephone_number": "800-746-6551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LESETMOE",
"first_name": "KAREN",
"middle_name": "J",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MN",
"license": "9483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crookston, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.