Kaitlyn Mellesmoen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13559 Issued in MN

Practice address

7400 France Ave S Ste 100
Edina, MN 55435-4738

Phone

(763) 537-6000

NPI assigned

Aug 20, 2021

Last updated

Nov 19, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kaitlyn Daggett Former name

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nura PLLCGroup PAC ID 2769378942, 33 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Nura PLLC

  • Pain Medicine Physician
  • Minneapolis, MN
  • NPI 1750316014
  Medicare reassignment Care Compare group
• Nura PLLC

  • Prosthetic/Orthotic Supplier
  • Woodbury, MN
  • NPI 1932995040
  NPD
• Minnesota Surgery Center, LTD.

  • Ambulatory Surgical Clinic/Center
  • Minneapolis, MN
  • NPI 1215056239
  NPD (past)

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1790451540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 NORTHDALE BLVD NW STE 220",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333046",
            "telephone_number": "763-537-6000",
            "fax_number": "763-537-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 FRANCE AVE S STE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354738",
            "telephone_number": "763-537-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2104 Northdale Blvd NW Ste 220",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554333046",
            "country_code": "US",
            "telephone_number": "763-537-6000",
            "fax_number": "763-537-6666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7390 France Ave S",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554354500",
            "country_code": "US",
            "telephone_number": "763-537-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELLESMOEN",
        "first_name": "KAITLYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BOARD OF MEDICAL PRACTICE PA LICENSURE",
            "identifier": "13559",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1166361",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kaitlyn.mellesmoen.p21@direct.painphysicians.nextgenshare.com",
            "affiliation": "N",
            "address_1": "7400 France Ave S # A",
            "city": "Edina",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554354738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "DAGGETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Melberry
• Janelle Jean Melgeorge Anderson, RD, LD
• Paul Jan Melichar, M.D.
• Jeffrey Stephen Mella, MD
• Peter Mellema, MD
• Trisha D Mellesmoen, PT
• Angelene M Mellick, MD
• Mellin Chiropractic Care Clinic, P.C.
• James Mellin II, D.C.
• Resmaa Menakem, MSW

• Physician Assistant in Edina, MN
• Providers in Edina, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; 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.

Verify at the official NPI Registry.