NPIMap

Individual provider Active NPI

Kristin Stankevitz, PA-C

  • Medical Physician Assistant
  • Chapel Hill, NC
National Provider Identifier
1417493008
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-06950 Issued in NC
Practice address
1728 Fordham Blvd
Chapel Hill, NC 27514-2397
Phone
(919) 968-1985
NPI assigned
Jan 6, 2017
Last updated
Jan 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-06950 NC Primary

Addresses

Primary practice location

1728 Fordham Blvd
Chapel Hill, NC 27514-2397

Mailing address

704 Constitution Dr Unit D
Durham, NC 27705-7500
Phone (920) 639-0421

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
I20191216000825 MN Practitioner - Physician Assistant 6507140746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

1285 Nininger Rd
Hastings, MN 55033-1086
Phone (651) 480-4200

1880 N Frontage Rd
Hastings, MN 55033-2687
Phone (612) 775-6200

225 Smith Ave N
Suite 400
St Paul, MN 55102-2568
Phone (651) 241-7176

2925 Chicago Ave
Minneapolis, MN 55407-1321

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13146MNMDPhysical Therapist
0010-06950NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jan 6, 2020 Accepting new patients
Allina Health System CurrentSince Jan 18, 2023 Accepting new patients
Allina Health System CurrentSince Jan 6, 2020 Accepting new patients
Allina Health System Past Accepting new patients
Capital Foot and Ankle Centers Past Accepting new patients
Med First Immediate Care & Family Practice PA Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

Interoperability endpoints

  • Direct secure messaging: kstankevitz458036@excellian.direct.allina.com

Organizations & group practices 8

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1417493008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 CONSTITUTION DR UNIT D",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277057500",
            "telephone_number": "920-639-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 FORDHAM BLVD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142397",
            "telephone_number": "919-968-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANKEVITZ",
        "first_name": "KRISTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-06950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.