Kathryn G Justesen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

42665 Issued in MN

Practice address

5502 W Broadway Ave
Crystal, MN 55428-3508

Phone

(763) 504-6500

Fax

(763) 504-6544

NPI assigned

Nov 3, 2005

Last updated

Jun 3, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Rush Medical College of Rush University, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Minnesota PhysiciansGroup PAC ID 9830001189, 158 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001
• Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214

Merit-based Incentive Payment System (MIPS)

Final score

86.67 of 100Reported as group

Quality

67.02

Promoting interoperability

99

Improvement activities

40

Cost

73.13

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjustesen1393@direct.northmemorial.com

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.

• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment Care Compare group NPD
• University of Minnesota Physicians

  dba M Physicians Broadway Family Medicine Clinic

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1366589962
  NPD
• University of Minnesota Physicians

  dba Dental Clinic

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD
• North Memorial Health Care

  dba North Memorial Health Hospital

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  NPD (past)
• Cardiothoracic Surgery Clinic of North Ms

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Tupelo, MS
  • NPI 1154533321
  NPD (past)

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

• Maple Grove Hospital Corporation

  • General Acute Care Hospital
  • Maple Grove, MN
  • NPI 1225272552
  Care Compare affiliation
• North Memorial Health Care

  dba North Memorial Ambulance Service

  • Ambulance
  • Brooklyn Center, MN
  • NPI 1538195912

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  dba North Memorial Health Specialty Center - Robbinsdale

  • Medical Specialty Clinic/Center
  • Robbinsdale, MN
  • NPI 1699953000

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  dba North Memorial Health Hospital

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Care Compare affiliation

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1598756041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5502 W BROADWAY AVE",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283508",
            "telephone_number": "763-504-6500",
            "fax_number": "763-504-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5502 W BROADWAY AVE",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283508",
            "telephone_number": "763-504-6500",
            "fax_number": "763-504-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTESEN",
        "first_name": "KATHRYN",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "42665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "762695900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiera Shawntay Johnson
• Sarah Mary Johnson, FNP-BC
• Karon L Jorges
• Joyful Health Services LLC
• Natalie Jane Juell
• Njil Kabamba I
• Jo Ellen Sullivan Kanne
• Carol M Karsnia, PA-C
• Kelly McGregory Pediatrics LLC
• Andrea D Keys, LADC

• Family Medicine Physician in Crystal, MN
• Providers in Crystal, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; 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.

Verify at the official NPI Registry.