Individual provider Active NPI

Dana Lynn Kaufman, PAC

  • Physician Assistant
  • Woodbury, MN
National Provider Identifier
1659387637
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10129 Issued in MN
Practice address
4040 Radio Dr
Woodbury, MN 55129-3237
Phone
(651) 439-8807
Fax
(651) 439-0232
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2040 WI
Surgical Physician Assistant 363AS0400X 10129 MN
Surgical Physician Assistant 363AS0400X 2040 WI
Physician Assistant 363A00000X 10129 MN Primary

Addresses

Primary practice location

4040 Radio Dr
Woodbury, MN 55129-3237

Mailing address

4200 Dahlberg Dr Ste 300
Golden Valley, MN 55422-4841
Phone (952) 512-5600

Other names 1

  • Dana Lynn Fleming 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
I20060810000563 MN Practitioner - Physician Assistant 2466455522 Reassigns benefits to 1 organization
I20060911000034 WI Practitioner - Physician Assistant 2466455522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

4040 Radio Dr
Woodbury, MN 55129-3237
Phone (651) 439-8807

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10129MNMDGeneral Practice Dentistry
2040WIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Jul 1, 2015 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jul 1, 2015 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

11225 Ulysses St NE
Blaine, MN 55434
Phone (763) 302-2600

5601 96th Ave N
Ste 200
Brooklyn Park, MN 55443
Phone (763) 786-9543

1000 W 140th St
Unit 201
Burnsville, MN 55337
Phone (952) 808-3000

2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600

8290 University Ave NE
Ste 200
Fridley, MN 55432
Phone (763) 786-9543

9630 Grove Cir N
Ste 200
Maple Grove, MN 55369
Phone (763) 520-7580

4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

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

5715 Memorial Ave N
Stillwater, MN 55082
Phone (514) 398-8076

3545 Highway 61 N
Vadnais Heights, MN 55110

4040 Radio Dr
Woodbury, MN 55129
Phone (514) 398-8076

5130 Fairview Blvd
Ste 100
Wyoming, MN 55092

411 Stageline Rd
#100
Hudson, WI 54016

2211 Vine St
Hudson, WI 54016
Phone (715) 386-1155

2651 Hillcrest Dr
Ste 101
Hudson, WI 54016
Phone (800) 423-1088

216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426

Organizations & group practices 4

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1659387637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR STE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224841",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 RADIO DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551293237",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "DANA",
        "middle_name": "LYNN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2040",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "10129",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "2040",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "FLEMING",
            "middle_name": "LYNN",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.