Individual provider Active NPI

Kelsey L. Miller, PA-C

  • Physician Assistant
  • Rochester, MN
National Provider Identifier
1700399292
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12591 Issued in MN
Practice address
1650 4TH St SE
Rochester, MN 55904-4717
Phone
(507) 529-6600
NPI assigned
Nov 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 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 12591 MN Primary

Addresses

Primary practice location

1650 4TH St SE
Rochester, MN 55904-4717

Mailing address

1650 4TH St SE
Rochester, MN 55904-4717
Phone (507) 529-6600

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
I20180108001149 MN Practitioner - Physician Assistant 6204195886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Olmsted Medical CenterGroup PAC ID 8527970060, 324 clinicians

Practice addresses (Care Compare)

1650 4TH St SE
Rochester, MN 55904-4717

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12591MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD. CurrentSince Jan 22, 2018 Accepting new patients
Olmsted Medical Center CurrentSince Sep 9, 2019 Accepting new patients
The Duluth Clinic LTD CurrentSince Jan 22, 2018 Accepting new patients
Ladd Memorial Hospital Past Accepting new patients

Locations

846 High Point Dr NE
Byron, MN 55920
Phone (507) 775-2128

1705 N Highway 20
Cannon Falls, MN 55009
Phone (507) 263-4900

207 Twiford St SW
Chatfield, MN 55923
Phone (507) 867-4901

115 10th Ave NE
#A
Deer River, MN 56636
Phone (218) 246-8275

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

507 W Doughty St
Lake City, MN 55041
Phone (651) 345-2350

111 County Road 11 NW
Pine Island, MN 55963
Phone (507) 356-2476

20 2nd Ave NE
Plainview, MN 55964
Phone (507) 534-3885

405 Kansas St NW
Preston, MN 55965
Phone (507) 765-5324

1650 4th St SE
Rochester, MN 55904
Phone (507) 285-8485

5067 55th St NW
Rochester, MN 55901
Phone (507) 292-7070

102 Elton Hills Dr NW
Ste 200
Rochester, MN 55901
Phone (507) 280-1824

5155 55th St NW
Rochester, MN 55901
Phone (507) 292-7174

90 14th St SW
Ste 200
Rochester, MN 55902
Phone (507) 280-1824

210 9th St SE
Rochester, MN 55904
Phone (507) 529-6616

4303 Highway 52 N
Rochester, MN 55901
Phone (507) 287-2714

1544 Greenview Dr SW
Rochester, MN 55902
Phone (507) 287-2711

132 17th Ave NW
Ste 132
Rochester, MN 55901
Phone (507) 292-7411

403 W 4th St
Saint Charles, MN 55972
Phone (507) 534-3885

802 Memorial Dr
Spring Valley, MN 55975
Phone (507) 346-7373

208 Ctr Town Plz N
Stewartville, MN 55976
Phone (507) 533-4727

Interoperability endpoints

  • Direct secure messaging: kmiller15453@direct.olmmed.org

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": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1700399292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 4TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559044717",
            "telephone_number": "507-529-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 4TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559044717",
            "telephone_number": "507-529-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELSEY",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.