Individual provider Active NPI

Jessica Marie Kratz, PA-C

  • Physician Assistant
  • Hayward, WI
National Provider Identifier
1619139995
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7072 Issued in WI
Practice address
11134 N State Road 77
Hayward, WI 54843-5325
Phone
(715) 634-5505
NPI assigned
Jun 27, 2008
Last updated
Oct 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10436 MN
Physician Assistant 363A00000X 7072 WI Primary

Addresses

Primary practice location

11134 N State Road 77
Hayward, WI 54843-5325

Mailing address

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

Other practice location 1

3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone (952) 993-3230

Other practice location 2

2828 Chicago Ave
Suite 200
Minneapolis, MN 55407
Phone (612) 879-1000

Other practice location 3

11091 Ulysses St.
Suite 100
Blaine, MN 55407
Phone (612) 879-1000

Other names 1

  • Jessica Marie Nelson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080910000672 MN Practitioner - Physician Assistant 3476629767 Reassigns benefits to 2 organizations
I20221025000561 WI Practitioner - Physician Assistant 3476629767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians
St Marys Hospital of SuperiorGroup PAC ID 8628964228, 96 clinicians

Practice addresses (Care Compare)

10405 Vermont Ave
Hayward, WI 54843-6111
Phone (715) 699-1355

11134 N State Rd
Hayward, WI 54843-5325
Phone (715) 634-5505

112 Ash St
Spooner, WI 54801-1487
Phone (715) 635-3979

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10436MNMDOral & Maxillofacial Surgery (D.M.D.)
7072WIMDPhysician Assistant
10434MNMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Feb 22, 2021 Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
St. Mary's Hospital of Superior CurrentSince Oct 24, 2022 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
Quest Diagnostics LLC Il Past Accepting new patients

Locations

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

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

3931 Louisiana Ave S
St Louis Park, MN 55426
Phone (952) 993-3230

11134 N State Road 77
Hayward, WI 54843
Phone (715) 634-5505

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Interoperability endpoints

  • Direct secure messaging: jessicakratz@direct.noranclinic.com

Organizations & group practices 8

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1619139995",
    "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",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11134 N STATE ROAD 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548435325",
            "telephone_number": "715-634-5505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3931 Louisiana Ave S",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554265000",
            "country_code": "US",
            "telephone_number": "952-993-3230",
            "fax_number": "952-993-1748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2828 Chicago Ave",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55407",
            "country_code": "US",
            "telephone_number": "612-879-1000",
            "fax_number": "612-879-9116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11091 Ulysses St.",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "55407",
            "country_code": "US",
            "telephone_number": "612-879-1000",
            "fax_number": "612-879-9116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRATZ",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10436",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "7072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "NELSON",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hayward, WI

Sources for this page

Verify at the official NPI Registry.