Active NPI
Mark E Kohlhase, PA-C
- Physician Assistant
- Wyoming, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9066
- Practice address
- 5200 Fairview Blvd
Wyoming, MN 55092-8013 - Phone
- (651) 982-7659
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9066 | MN | Primary |
Addresses
Primary practice location
5200 Fairview Blvd
Wyoming, MN 55092-8013
Mailing address
10490 261St St
Chisago City, MN 55013-5201
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000
717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.63 of 100
- Quality
- 75.41
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.75
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients |
Locations
14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273
5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611
Interoperability endpoints
- mkohlhase7133@fairview.direct-ci.com
Organizations & group practices 10
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1346432218
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
- Clinic/Center
- Minneapolis, MN
- NPI 1588543862
-
- Primary Care Clinic/Center
- Saint Paul, MN
- NPI 1396552147
-
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1598072183
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
- Cardiovascular Disease Physician
- Burnsville, MN
- NPI 1891930442
-
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
-
- Hospitalist Physician
- Edina, MN
- NPI 1770663031
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1730131228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10490 261ST ST",
"city": "CHISAGO CITY",
"state": "MN",
"postal_code": "550135201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 FAIRVIEW BLVD",
"city": "WYOMING",
"state": "MN",
"postal_code": "550928013",
"telephone_number": "651-982-7659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLHASE",
"first_name": "MARK",
"middle_name": "E",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "9066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wyoming, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.