Individual provider Active NPI

Krystin Nicole Svobodny

  • Physician Assistant
  • Chanhassen, MN
National Provider Identifier
1790426609
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone
(952) 934-0570
NPI assigned
Apr 5, 2022
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 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 NU Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

7907 Powers Blvd
Chanhassen, MN 55317-9502

Mailing address

7907 Powers Blvd
Chanhassen, MN 55317-9502

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
I20230919003863 MN Practitioner - Physician Assistant 8325402654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Medical Center CurrentSince Aug 28, 2023 Accepting new patients

Locations

165 W Commerce Dr
Belle Plaine, MN 56011
Phone (952) 777-5661

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

916 Saint Peter Ave E
Delano, MN 55328
Phone (763) 972-9172

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Organizations & group practices 2

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 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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1790426609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7907 POWERS BLVD",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7907 POWERS BLVD",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179502",
            "telephone_number": "952-934-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SVOBODNY",
        "first_name": "KRYSTIN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chanhassen, MN

Sources for this page

Verify at the official NPI Registry.