Individual provider Active NPI

Kelly R Linnihan

  • Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1447640495
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11779 Issued in MN
Practice address
1050 Larpenteur Ave W
Saint Paul, MN 55113-6556
Phone
(651) 788-4444
Fax
(651) 487-1705
NPI assigned
Jan 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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 11779 MN Primary

Addresses

Primary practice location

1050 Larpenteur Ave W
Saint Paul, MN 55113-6556

Mailing address

2025 Sloan PL Ste 35
Saint Paul, MN 55117-2092
Phone (651) 772-1572

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150321000162 MN Practitioner - Physician Assistant 7618294117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Healthservices Minnesota PAGroup PAC ID 1355369018, 55 clinicians
Optage IncGroup PAC ID 2264619345, 61 clinicians

Practice addresses (Care Compare)

1050 Larpenteur Ave W
Saint Paul, MN 55113-6556
Phone (651) 788-4444

234 Wentworth Ave E
West St Paul, MN 55118-3525
Phone (651) 788-4444

2601 Centennial Dr
Suite 100
North St Paul, MN 55109-3087
Phone (651) 788-4444

2945 Lincoln Dr
Roseville, MN 55113-1338
Phone (651) 631-6570

3550 Labore Rd
Suite 7
Vadnais Heights, MN 55110-5113
Phone (651) 788-4444

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthservices Minnesota, P.a. CurrentSince Mar 15, 2015 Accepting new patients
East Metro Family Practice, P.a. Past Accepting new patients
Family Healthservices Minnesota, P.a. Past Accepting new patients

Locations

2601 Centennial Dr
Ste 100
Saint Paul, MN 55109
Phone (651) 777-7414

1050 Larpenteur Ave W
Saint Paul, MN 55113
Phone (651) 487-2831

2025 Sloan Pl
Ste 35
Saint Paul, MN 55117
Phone (651) 772-1572

Interoperability endpoints

  • Direct secure messaging: kelly.linnihan@entira.eclinicaldirectplus.com

Organizations & group practices 4

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": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1447640495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL STE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172092",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LARPENTEUR AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551136556",
            "telephone_number": "651-788-4444",
            "fax_number": "651-487-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINNIHAN",
        "first_name": "KELLY",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.