Active NPI
Kathryn Jelle, PA-C
- Medical Physician Assistant
- St Louis Park, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 11839
- Practice address
- 3931 Louisiana Ave S # 55426
St Louis Park, MN 55426-5000 - Phone
- (952) 993-3248
- NPI assigned
- Jul 30, 2015
- 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 | 11839 | MN | Primary |
Addresses
Primary practice location
3931 Louisiana Ave S # 55426
St Louis Park, MN 55426-5000
Mailing address
3931 Louisiana Ave S # 55426
St Louis Park, MN 55426-5000
Phone (952) 993-3248
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
Enrollment records 1
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
Practice addresses (Care Compare)
1415 Saint Francis Ave
Shakopee, MN 55379-3374
Phone (952) 993-7750
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
8401 Golden Valley Rd
Golden Valley, MN 55427-4486
Phone (952) 993-8300
Hospital & facility affiliations
- Park Nicollet Methodist Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11839 | MN | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Current | Accepting new patients |
Locations
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
3931 Louisiana Ave S
St Louis Park, MN 55426
Phone (952) 993-3230
Organizations & group practices 2
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.
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1063897593
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maple Grove, MN
- NPI 1174980692
-
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1194113217
-
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1245615772
-
- Mental Illness Community Based Residential Treatment Facility
- St Louis Park, MN
- NPI 1578717336
Hospital
-
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1649220724
-
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1942585286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438214400000",
"number": "1538545686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3931 LOUISIANA AVE S # 55426",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554265000",
"telephone_number": "952-993-3248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3931 LOUISIANA AVE S # 55426",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554265000",
"telephone_number": "952-993-3248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JELLE",
"first_name": "KATHRYN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-30",
"last_updated": "2015-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MN",
"license": "11839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; 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.