Individual provider Active NPI

Kyle R Exsted, PAC

  • Surgical Physician Assistant
  • Robbinsdale, MN
National Provider Identifier
1669679486
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10293 Issued in MN
Practice address
3366 Oakdale Ave N
Suites 103 & 104
Robbinsdale, MN 55422-2948
Phone
(763) 520-7870
Fax
(763) 520-7889
NPI assigned
Jun 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 10293 MN
Surgical Physician Assistant 363AS0400X 10293 MN Primary

Addresses

Primary practice location

3366 Oakdale Ave N
Suites 103 & 104
Robbinsdale, MN 55422-2948

Mailing address

4200 Dahlberg Dr
Suite 300
Golden Valley, MN 55422-4840
Phone (952) 512-5600

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071022000604 MN Practitioner - Physician Assistant 1759477706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
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)

1000 W 140TH St
Unit 201
Burnsville, MN 55337-4833
Phone (952) 808-3000

111 Hundertmark Rd
Suite 240
Chaska, MN 55318-1198
Phone (952) 456-7400

11225 Ulysses St NE
Blaine, MN 55434-4261
Phone (763) 302-2600

16800 37TH PL N
Plymouth, MN 55446-2805
Phone (763) 520-7870

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

4010 W 65TH St
Edina, MN 55435-1706
Phone (952) 456-7000

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

4100 Minnesota Dr
Edina, MN 55435-5417
Phone (952) 456-7000

5601 96TH Ave N
Brooklyn Park, MN 55443-4505
Phone (763) 786-9543

5715 Memorial Ave N
Oak Park Heights, MN 55082-1093
Phone (651) 439-8807

820 Village Way
Waconia, MN 55387-4612

9630 Grove Cir N
Suite 200
Maple Grove, MN 55369-3492
Phone (763) 520-7870

Hospital & facility affiliations

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
10293MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Apr 1, 2011 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Apr 1, 2011 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

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

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

7866 12th Ave S
Minneapolis, MN 55425

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

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

16800 37th Pl N
#200
Plymouth, MN 55446
Phone (635) 207-8707

3366 Oakdale Ave N
Ste 103
Robbinsdale, MN 55422

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

820 Village Way
#200
Waconia, MN 55387

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

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.

Hospital & facility affiliations 2

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1669679486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR",
            "address_2": "SUITE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224840",
            "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": "3366 OAKDALE AVE N",
            "address_2": "SUITES 103 & 104",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222948",
            "telephone_number": "763-520-7870",
            "fax_number": "763-520-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXSTED",
        "first_name": "KYLE",
        "middle_name": "R",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10293",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "10293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.