NPIMap

Individual provider Active NPI

Katelyn Jenelle Mohrbacher, MD

  • Family Medicine Physician
  • Ashland, WI
National Provider Identifier
1659631919
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
70653 Issued in WI
Practice address
2201 Lake Shore Dr E
Ashland, WI 54806
Phone
(715) 685-6600
Fax
(715) 685-6601
NPI assigned
May 21, 2012
Last updated
Dec 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 70653 WI Primary
Family Medicine Physician 207Q00000X 56647 MN

Addresses

Primary practice location

2201 Lake Shore Dr E
Ashland, WI 54806

Mailing address

2201 Lake Shore Dr E
Ashland, WI 54806-2331
Phone (715) 685-6600

Other practice location 1

1210 1st St W
Hastings, MN 55033-1147
Phone (651) 438-1800

Other practice location 2

1210 1st St W
Hastings, MN 55033-1147
Phone (651) 438-1800

Other identifiers 4

IdentifierTypeStateIssuer
1659631919MedicaidMN
0001-0105078OtherMEDICA
1659631919OtherMNBCBS
P01224926OtherRR MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmohrbacher290519@excellian.direct.allina.com Direct
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20190606002436 WI Practitioner - Family Practice 9638311715 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Medical Center IncGroup PAC ID 8022000447, 80 clinicians
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

1615 Maple LN
Ashland, WI 54806-3626
Phone (715) 682-5500

2201 Lake Shore Dr E
Ashland, WI 54806-2331
Phone (715) 685-6600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Jun 21, 2019 Accepting new patients
St. Luke's Hospital of Duluth Family Medicine CurrentSince Jun 21, 2019 Accepting new patients
Memorial Medical Center Inc CurrentSince Jul 1, 2025 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
Memorial Medical Center Inc CurrentSince Jul 1, 2025 Accepting new patients
Medical Services, Inc Current Accepting new patients
The Duluth Clinic, LTD. PastSince Jul 13, 2013 Accepting new patients
Medical Services, Inc Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

2201 Lake Shore Dr E
Ashland, WI 54806
Phone (715) 685-6600

11040 N State Road 77
Hayward, WI 54843
Phone (715) 934-4244

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Interoperability endpoints

  • Direct secure messaging: kmohrbacher237516@direct.aspirus.org

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 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1659631919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 LAKE SHORE DR E",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548062331",
            "telephone_number": "715-685-6600",
            "fax_number": "715-685-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 LAKE SHORE DR E",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "54806",
            "telephone_number": "715-685-6600",
            "fax_number": "715-685-6601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1210 1st St W",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "MN",
            "postal_code": "550331147",
            "country_code": "US",
            "telephone_number": "651-438-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1210 1st St W",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "MN",
            "postal_code": "550331147",
            "country_code": "US",
            "telephone_number": "651-438-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHRBACHER",
        "first_name": "KATELYN",
        "middle_name": "JENELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "70653",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "56647",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659631919",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0001-0105078",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1659631919",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01224926",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmohrbacher290519@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1210 1st St W",
            "city": "Hastings",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550331147",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "2201 Lake Shore Dr E",
            "city": "Ashland",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ashland, WI

Sources for this page

Verify at the official NPI Registry.