Individual provider Active NPI

Jeffrey T Kvant, PA-C

  • Physician Assistant
  • Monticello, MN
National Provider Identifier
1881614766
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9481 Issued in MN
Practice address
1001 Hart Blvd Ste 100
Monticello, MN 55362-8929
Phone
(763) 295-2921
Fax
(763) 581-9090
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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 9481 MN Primary

Addresses

Primary practice location

1001 Hart Blvd Ste 100
Monticello, MN 55362-8929

Mailing address

1700 Highway 25 N
Buffalo, MN 55313-1930
Phone (763) 682-1313

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkvant15571@direct.northmemorial.com

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
I20051117000063 MN Practitioner - Physician Assistant 6204855422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stellis Health, PAGroup PAC ID 1153233796, 54 clinicians

Practice addresses (Care Compare)

1001 Hart Blvd
Suite 100
Monticello, MN 55362-8929
Phone (763) 682-1313

1700 Hwy 25 N
Buffalo, MN 55313-1930
Phone (763) 682-1313

Hospital & facility affiliations

  • Triniti Home Health and Hospice Home health agency, Elk River, MN, CCN 247263
  • Centracare Health - Monticello Hospital, Monticello, MN, CCN 241362

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stellis Health, PA CurrentSince Nov 2, 2005 Accepting new patients
Stellis Health, PA CurrentSince Nov 2, 2005 Accepting new patients

Locations

11091 Jason Ave NE
Albertville, MN 55301
Phone (763) 315-5000

1700 Highway 25 N
Hanover, MN 55313
Phone (763) 682-1313

1001 Hart Blvd
Ste 100
Monticello, MN 55362
Phone (763) 295-2921

Interoperability endpoints

  • Direct secure messaging: jkvant15571@direct.northmemorial.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1881614766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HIGHWAY 25 N",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131930",
            "telephone_number": "763-682-1313",
            "fax_number": "763-581-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HART BLVD STE 100",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628929",
            "telephone_number": "763-295-2921",
            "fax_number": "763-581-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVANT",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkvant15571@direct.northmemorial.com",
            "affiliation": "N",
            "address_1": "1001 Hart Blvd Ste 100",
            "city": "Monticello",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553628929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monticello, MN

Sources for this page

Verify at the official NPI Registry.