Individual provider Active NPI

Kaitlyn Mae Buchholz

  • Physician Assistant
  • Burnsville, MN
National Provider Identifier
1821657065
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone
(952) 892-2000
NPI assigned
Jun 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 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 Primary

Addresses

Primary practice location

201 E Nicollet Blvd
Burnsville, MN 55337-5714

Mailing address

5045 Kagan Ave NE
Albertville, MN 55301-3521
Phone (320) 219-8566

Other practice location 1

5045 Kagan Ave NE
Albertville, MN 55301-3521
Phone (320) 219-8566

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
I20190813002668 MN Practitioner - Physician Assistant 9234466269 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-1313

919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344

Hospital & facility affiliations

  • M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13101MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Bethesda Hospital CurrentSince Mar 23, 2020 Accepting new patients
Fairview Clinics CurrentSince Mar 23, 2020 Accepting new patients
Fairview Health Services CurrentSince Sep 14, 2019 Accepting new patients
Fairview Clinics CurrentSince Mar 23, 2020 Accepting new patients
Fairview Health Services CurrentSince Sep 14, 2019 Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 25, 2020 Accepting new patients

Locations

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: kbuchholz489273@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.

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": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1821657065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5045 KAGAN AVE NE",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "553013521",
            "telephone_number": "320-219-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E NICOLLET BLVD",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553375714",
            "telephone_number": "952-892-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5045 Kagan Ave NE",
            "address_purpose": "LOCATION",
            "city": "Albertville",
            "state": "MN",
            "postal_code": "553013521",
            "country_code": "US",
            "telephone_number": "320-219-8566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCHHOLZ",
        "first_name": "KAITLYN",
        "middle_name": "MAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.