Individual provider Active NPI

John R. K. Kass, PA-C

  • Physician Assistant
  • Marshall, MN
National Provider Identifier
1821351255
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11391 Issued in MN
Practice address
300 S Bruce St
Marshall, MN 56258-1934
Phone
(507) 537-9007
Fax
(507) 537-2734
NPI assigned
Jun 20, 2012
Last updated
Apr 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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 0820 SD
Physician Assistant 363A00000X 11391 MN Primary

Addresses

Primary practice location

300 S Bruce St
Marshall, MN 56258-1934

Mailing address

300 S Bruce St
Marshall, MN 56258-1934
Phone (507) 537-9007

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
I20160523000645 MN Practitioner - Physician Assistant 7012147754 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Sanford School of Medicine of University of South Dakota, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera MarshallGroup PAC ID 5799695227, 102 clinicians

Practice addresses (Care Compare)

300 S Bruce St
Marshall, MN 56258-1934
Phone (507) 537-9165

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11391MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Marshall CurrentSince Apr 20, 2016 Accepting new patients
Avera Marshall CurrentSince Jan 1, 2026 Accepting new patients
Avera Granite Falls Physician Assistant CurrentSince Jan 14, 2020 Accepting new patients
Avera Marshall CurrentSince Apr 20, 2016 Accepting new patients
Avera Tyler Past Accepting new patients
Granite Falls Municipal Hospital and Manor Past Accepting new patients
Avera Marshall Past Accepting new patients

Locations

345 10th Ave
Granite Falls, MN 56241
Phone (320) 564-3111

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

Organizations & group practices 7

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1821351255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S BRUCE ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562581934",
            "telephone_number": "507-537-9007",
            "fax_number": "507-537-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S BRUCE ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562581934",
            "telephone_number": "507-537-9007",
            "fax_number": "507-537-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASS",
        "first_name": "JOHN",
        "middle_name": "R. K.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0820",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MN

Sources for this page

Verify at the official NPI Registry.