NPIMap

Individual provider Active NPI

Summer Kubalak, PA

  • Physician Assistant
  • Edina, MN
National Provider Identifier
1639860083
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14770 Issued in MN
Practice address
6363 France Ave S Ste 400
Edina, MN 55435-2142
Phone
(651) 312-1700
NPI assigned
May 17, 2023
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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 14770 MN Primary

Addresses

Primary practice location

6363 France Ave S Ste 400
Edina, MN 55435-2142

Mailing address

3500 American Blvd W Ste 300
Bloomington, MN 55431-4442
Phone (952) 512-5600

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
I20240129002106 MN Practitioner - Physician Assistant 5698128411 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minnesota Oncology Hematology PAGroup PAC ID 6709799752, 131 clinicians
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

310 N Smith Ave
Suite 100
Saint Paul, MN 55102-2379
Phone (651) 251-5500

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

6545 France Ave S
Suite 210
Edina, MN 55435-2281
Phone (952) 928-2900

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

7760 France Ave S
Suite 1000
Bloomington, MN 55435-5870
Phone (952) 749-6767

911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-1313

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Mar 11, 2024 Accepting new patients
Minnesota Oncology Hematology, PA CurrentSince Oct 1, 2025 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Mar 11, 2024 Accepting new patients
Fairview Health Services CurrentSince Jul 1, 2025 Accepting new patients
Fairview Health Services CurrentSince Jul 1, 2025 Accepting new patients
Minnesota Oncology Hematology PA CurrentSince Oct 1, 2025 Accepting new patients
Fairview Express Care CurrentSince Aug 1, 2024 Accepting new patients
Fairview Express Care CurrentSince Aug 1, 2024 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
Fairview Express Care Past Accepting new patients
Minnesota Oncology Hematology, PA Past Accepting new patients
Minnesota Oncology Hematology, PA PastSince Jan 12, 2020 Accepting new patients
Minnesota Oncology Hematology, PA Past Accepting new patients

Locations

14101 Fairview Dr
Ste 280
Burnsville, MN 55337
Phone (651) 312-1700

675 E Nicollet Blvd
Ste 135
Burnsville, MN 55337
Phone (952) 892-2650

11850 Blackfoot St NW
Ste 270
Coon Rapids, MN 55433
Phone (651) 312-1711

2945 Hazelwood St
Ste 340
Maplewood, MN 55109
Phone (651) 312-1620

3500 American Blvd W
Ste 300
Minneapolis, MN 55431
Phone (952) 512-5600

6363 France Ave S
Ste 400
Minneapolis, MN 55435
Phone (651) 312-1700

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

2550 University Ave W
Ste 110N
Saint Paul, MN 55114
Phone (651) 602-5309

310 Smith Ave N
Ste 100
Saint Paul, MN 55102
Phone (651) 251-5500

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1639860083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 AMERICAN BLVD W STE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314442",
            "telephone_number": "952-512-5600",
            "fax_number": "952-512-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 FRANCE AVE S STE 400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352142",
            "telephone_number": "651-312-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBALAK",
        "first_name": "SUMMER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.