Individual provider Active NPI

Kate Meredith Whelan Suda, PA-C

  • Physician Assistant
  • Grafton, ND
National Provider Identifier
1952866725
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0764 Issued in ND
Practice address
1113 W 11TH St
Grafton, ND 58237-2139
Phone
(701) 352-4048
Fax
(701) 922-1308
NPI assigned
Feb 6, 2019
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 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 PAC0764 ND Primary

Addresses

Primary practice location

1113 W 11TH St
Grafton, ND 58237-2139

Mailing address

1113 W 11TH St
Grafton, ND 58237-2139
Phone (701) 352-4048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20190227001575 ND Practitioner - Physician Assistant 4880933357 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Community Health Service IncGroup PAC ID 4486930195, 7 clinicians

Practice addresses (Care Compare)

1113 W 11TH St
Grafton, ND 58237-2139
Phone (701) 352-4048

2310 4TH Ave N
Moorhead, MN 56560-2473

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Service Inc. CurrentSince Sep 1, 2023 Accepting new patients
Altru Health System CurrentSince Feb 4, 2019 Accepting new patients
Altru Health System CurrentSince Feb 4, 2019 Accepting new patients
Community Health Service Inc. Past Accepting new patients
Community Health Service Inc. PastSince Sep 24, 2023 Accepting new patients

Locations

2310 4th Ave N
Moorhead, MN 56560
Phone (218) 236-6502

1003 N Main St
Drayton, ND 58225
Phone (701) 454-3311

1113 W 11th St
Grafton, ND 58237
Phone (701) 352-4048

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

Interoperability endpoints

  • Direct secure messaging: ksuda817364@direct.ochin.org

Organizations & group practices 6

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 1

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": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1952866725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 W 11TH ST",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582372139",
            "telephone_number": "701-352-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 W 11TH ST",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582372139",
            "telephone_number": "701-352-4048",
            "fax_number": "701-922-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDA",
        "first_name": "KATE",
        "middle_name": "MEREDITH WHELAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, ND

Sources for this page

Verify at the official NPI Registry.