Jeffrey Owen Kasbohm, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9692 Issued in MN

Practice address

6341 University Ave NE
Fridley, MN 55432-4946

Phone

(763) 572-5710

Fax

(763) 586-5888

NPI assigned

Sep 1, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

92.35 of 100Reported as group

Quality

91.74

Promoting interoperability

100

Improvement activities

40

Cost

77.13

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Fairview Clinics

  dba Fairview Clinics-Hiawatha

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment
• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Healtheast Medical Research Institute

  dba HealthEast Vadnais Heights Clinic

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment
• Shakopee Mdewakanton Sioux Community

  dba Shakopee Dakota Clinic

  • Family Medicine Physician
  • Prior Lake, MN
  • NPI 1013933381
  Medicare reassignment
• Fairview Clinics

  dba Fairview Clinics-Eden Prairie

  • Primary Care Clinic/Center
  • Eden Prairie, MN
  • NPI 1336331297
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Express Care

  • Clinic/Center
  • Burnsville, MN
  • NPI 1992075501
  NPD
• Fairview Health Services

  • Family Medicine Physician
  • Wyoming, MN
  • NPI 1417037896
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Fairview Health Services

  dba Fairview Northland Hospital

  • General Acute Care Hospital
  • Princeton, MN
  • NPI 1922085299
  NPD

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1447352547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 UNIVERSITY AVE NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324341",
            "telephone_number": "763-572-5710",
            "fax_number": "763-571-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6341 UNIVERSITY AVE NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324946",
            "telephone_number": "763-572-5710",
            "fax_number": "763-586-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASBOHM",
        "first_name": "JEFFREY",
        "middle_name": "OWEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1030604",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0110266",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MN",
            "identifier": "141816",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "64G07KA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "1639459",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP35076",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA URGENT CARE",
            "identifier": "6605100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Kangar
• Bodhi Kikue Kannon, M.D.
• Juihsien Hung Kao
• Kelly Marie Karjalahti, MA, LPC
• Heather Rose Karson, LICSW
• Lisa C Kastenbauer, LMFT
• Kayo Health Care Center LLC
• Tiana Kazemi
• Kci USA, Inc. (Solventum Advanced Wound Care)
• James William Keane, MD

• Physician Assistant in Fridley, MN
• Providers in Fridley, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.