NPIMap

Individual provider Active NPI

Colleen N Kuzj, PA

  • Physician Assistant
  • St Louis Park, MN
National Provider Identifier
1518330570
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12002 Issued in MN
Practice address
3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone
(952) 993-3230
Fax
(952) 993-1748
NPI assigned
Nov 12, 2015
Last updated
Jul 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MN
Physician Assistant 363A00000X 12002 MN Primary
Trauma Surgery Physician 2086S0127X 12002 MN

Addresses

Primary practice location

3931 Louisiana Ave S
St Louis Park, MN 55426-5000

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

347 Smith Ave N Ste 203
Saint Paul, MN 55102-2388
Phone (651) 241-7733

Other practice location 2

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-3700

Other identifiers 1

IdentifierTypeStateIssuer
363A00000XMedicaidMN

Other names 1

  • Colleen N Mooney Former name

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
I20160122000404 MN Practitioner - Physician Assistant 8628371853 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

15800 95TH Ave N
Maple Grove, MN 55369-4400
Phone (952) 993-1440

3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone (952) 993-3123

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12002MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Aug 21, 2023 Accepting new patients
Allina Health System CurrentSince Jun 1, 2020 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Park Nicollet Clinic CurrentSince Aug 21, 2023 Accepting new patients
North Memorial Health Care CurrentSince Jan 9, 2016 Accepting new patients
Allina Health System CurrentSince Jun 1, 2020 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
Minneapolis, MN 55407
Phone (612) 262-4813

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

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

347 Smith Ave N
Ste 203
Saint Paul, MN 55102
Phone (651) 241-7733

3931 Louisiana Ave S
St Louis Park, MN 55426
Phone (952) 993-3230

Organizations & group practices 9

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 6

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": "1447286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1518330570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3931 LOUISIANA AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554265000",
            "telephone_number": "952-993-3230",
            "fax_number": "952-993-1748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "347 Smith Ave N Ste 203",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551022388",
            "country_code": "US",
            "telephone_number": "651-241-7733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 Oakdale Ave N",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "554222926",
            "country_code": "US",
            "telephone_number": "763-581-3700",
            "fax_number": "763-581-3701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUZJ",
        "first_name": "COLLEEN",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-12",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12002",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MN",
            "license": "12002",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363A00000X",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "MOONEY",
            "middle_name": "N",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.