NPIMap

Individual provider Active NPI

Kelly Nicole Giles, PA-C

  • Physician Assistant
  • Bloomington, MN
National Provider Identifier
1568829315
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12076 Issued in MN
Practice address
4300 Marketpointe Dr Ste 100
Bloomington, MN 55435
Phone
(952) 835-9880
Fax
(952) 857-1554
NPI assigned
Jan 25, 2016
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 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 12076 MN Primary

Addresses

Primary practice location

4300 Marketpointe Dr Ste 100
Bloomington, MN 55435

Mailing address

4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435
Phone (952) 835-9880

Other names 1

  • Kelly Nicole Comstock 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
I20160331001796 MN Practitioner - Physician Assistant 1355648635 Reassigns benefits to 1 organization

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)

1159 County Rd E E
Vadnais Heights, MN 55110-5183
Phone (651) 789-6500

3010 Denmark Ave
Eagan, MN 55121-2271
Phone (651) 789-9900

4300 Marketpointe Dr
Suite 100
Bloomington, MN 55435-5435
Phone (952) 835-9880

7115 Tamarack Rd
Suite 150
Woodbury, MN 55125-1208
Phone (651) 789-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2448MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Professional Association CurrentSince May 1, 2016 Accepting new patients
Emergency Physicians Professional Association Past Accepting new patients

Locations

4300 Marketpointe Dr
Ste 100
Minneapolis, MN 55435
Phone (952) 767-4574

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1568829315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 MARKETPOINTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARKETPOINTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILES",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-25",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "COMSTOCK",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.