Active NPI
Kathryn E Decker, PA
- Physician Assistant
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12780
- Practice address
- 909 Fulton St SE
Minneapolis, MN 55455-4800 - Phone
- (612) 672-7422
- NPI assigned
- Jun 22, 2011
- Last updated
- Dec 22, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA054902 | PA | |
| Physician Assistant | 363A00000X | 12780 | MN | Primary |
Addresses
Primary practice location
909 Fulton St SE
Minneapolis, MN 55455-4800
Mailing address
909 Fulton St SE
Minneapolis, MN 55455-4800
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, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7000
1700 University Ave W
Saint Paul, MN 55104-3727
201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000
6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000
6545 France Ave S
Suite 450
Edina, MN 55435-2122
Phone (952) 924-1520
717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422
911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-6353
919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12780 | MN | MD | Physical Therapist |
| MA054902 | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Minnesota Physicians | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| University of Minnesota Physicians | Current | Accepting new patients | |
| Grand Itasca Clinic and Hospital | Current | Accepting new patients | |
| Healtheast Medical Research Institute | Current | Accepting new patients | |
| University of Minnesota Health Clinics and Surgery Center Inc | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Health Services | Past | Accepting new patients |
Locations
6545 France Ave S
Ste 450
Edina, MN 55435
Phone (612) 626-6688
111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401
720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0331
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649
6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477
909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273
1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000
45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000
1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100
Interoperability endpoints
- kbard450988@fairview.direct-ci.com
Organizations & group practices 16
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.
-
dba M Health Fairview Recovery Clinic
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
dba HealthEast Vadnais Heights Clinic
- Clinic/Center
- Vadnais Heights, MN
- NPI 1639125503
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
- General Acute Care Hospital
- Grand Rapids, MN
- NPI 1669426631
-
- Clinic/Center
- Minneapolis, MN
- NPI 1053795187
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
-
dba M Health Fairview Orthopedic Clinic - Blaine
- Multi-Specialty Clinic/Center
- Blaine, MN
- NPI 1417277294
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
- Family Medicine Physician
- Wyoming, MN
- NPI 1417037896
-
dba Fairview Emergency Medical Services
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
-
dba Grand Itasca Pharmacy
- Community/Retail Pharmacy
- Grand Rapids, MN
- NPI 1225441157
-
dba HealthEast Professional Services
- Internal Medicine Physician
- Saint Paul, MN
- NPI 1508191552
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Fairview Hospital University
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
dba Fairview Southdale Hospital
- General Acute Care Hospital
- Edina, MN
- NPI 1699752915
-
dba Fairview Diagnostic Laboratory
- General Acute Care Hospital
- Edina, MN
- NPI 1932260833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766361600000",
"number": "1558657064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 FULTON ST SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554554800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 FULTON ST SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554554800",
"telephone_number": "612-672-7422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECKER",
"first_name": "KATHRYN",
"middle_name": "E",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-22",
"last_updated": "2025-12-22",
"certification_date": "2025-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA054902",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "12780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.