Individual provider Active NPI

Keith D Stueve, PA

  • Medical Physician Assistant
  • Shakopee, MN
National Provider Identifier
1871235564
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
7166 Issued in WI
Practice address
4201 Dean Lakes Blvd Ste 120
Shakopee, MN 55379-2850
Phone
(952) 496-6700
NPI assigned
Apr 12, 2022
Last updated
Jul 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 7166 WI Primary
Physician Assistant 363A00000X 15655 MN

Addresses

Primary practice location

4201 Dean Lakes Blvd Ste 120
Shakopee, MN 55379-2850

Mailing address

PO Box 43
Minneapolis, MN 55440-0043

Other practice location 1

402 W Lake St
Friendship, WI 53934-9699
Phone (608) 339-6350

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kstueve812675@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20230413003032 WI Practitioner - Physician Assistant 0143695684 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

402 W Lake St
Friendship, WI 53934-9699
Phone (608) 339-3331

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7166WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Apr 17, 2023 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc CurrentSince Jan 5, 2026 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Apr 17, 2023 Accepting new patients

Locations

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

Interoperability endpoints

  • Direct secure messaging: kstueve759019@direct.emplifyhealth.org

Organizations & group practices 3

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": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1871235564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 DEAN LAKES BLVD STE 120",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792850",
            "telephone_number": "952-496-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 W Lake St",
            "address_purpose": "LOCATION",
            "city": "Friendship",
            "state": "WI",
            "postal_code": "539349699",
            "country_code": "US",
            "telephone_number": "608-339-6350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUEVE",
        "first_name": "KEITH",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-12",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "7166",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15655",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kstueve812675@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cda/pdf/txt",
            "address_1": "4201 Dean Lakes Blvd Ste 120",
            "city": "Shakopee",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553792850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.