Individual provider Active NPI

Katherine Huber, PA-C

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1578075198
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14229 Issued in MN
Practice address
1502 London Rd Ste 102
Duluth, MN 55812-1787
Phone
(218) 576-0100
NPI assigned
Nov 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 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 14229 MN Primary

Addresses

Primary practice location

1502 London Rd Ste 102
Duluth, MN 55812-1787

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951

Other practice location 1

2211 Riverside Ave
Minneapolis, MN 55454-1350
Phone (612) 330-1000

Other practice location 2

576 Bielenberg Dr Ste 250
Woodbury, MN 55125-1739
Phone (651) 645-5323

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
I20221116002031 MN Practitioner - Physician Assistant 7416210836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians

Practice addresses (Care Compare)

1502 London Rd
Suite 102
Duluth, MN 55812-1787
Phone (218) 727-8228

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

  • Essentia Health Duluth Hospital, Duluth, MN, CCN 240019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
14229MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD CurrentSince Nov 21, 2022 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Nov 21, 2022 Accepting new patients

Locations

4621 E Superior St
Duluth, MN 55804
Phone (218) 786-3550

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1502 London Rd
Ste 102
Duluth, MN 55812
Phone (218) 576-0100

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

211 S Boundary Ave
Proctor, MN 55810
Phone (218) 624-4818

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1509840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1578075198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 LONDON RD STE 102",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121787",
            "telephone_number": "218-576-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554541350",
            "country_code": "US",
            "telephone_number": "612-330-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "576 Bielenberg Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551251739",
            "country_code": "US",
            "telephone_number": "651-645-5323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBER",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-05",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.