NPIMap

Individual provider Active NPI

Kaitlyn Rose Schoeck, MD

  • Family Medicine Physician
  • Staples, MN
National Provider Identifier
1972913119
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
59528 Issued in MN
Practice address
49725 County 83
Staples, MN 56479-5280
Phone
(218) 894-1515
NPI assigned
Apr 28, 2014
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 59528 MN Primary

Addresses

Primary practice location

49725 County 83
Staples, MN 56479-5280

Mailing address

49725 County 83
Staples, MN 56479-5280
Phone (218) 894-1515

Other names 1

  • Kaitlyn Rose Pelowski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150723008863 MN Practitioner - Family Practice 4385957042 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakewood Health SystemGroup PAC ID 1052229671, shared by 15 NPIs, 107 clinicians

Practice addresses (Care Compare)

49725 County
Suite 83
Staples, MN 56479-5280
Phone (218) 894-1515

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59528MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Health System CurrentSince Aug 1, 2017 Accepting new patients
Lakewood Health System CurrentSince Aug 1, 2017 Accepting new patients
Lakewood Health System CurrentSince Aug 1, 2017 Accepting new patients
Healtheast Medical Research Institute CurrentSince Dec 1, 2015 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Dec 1, 2015 Accepting new patients
Lakewood Health System Current Accepting new patients
Lakewood Health System Past Accepting new patients

Locations

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0331

653 Pillsbury St N
Ste 1
Pillager, MN 56473
Phone (218) 746-4550

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

49725 County 83
Staples, MN 56479
Phone (218) 894-1033

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: kschoeck625578@direct.ochin.org

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lakewood Health SystemStaples, MN, CCN 241329 Hospital Corporate Director Aug 7, 2017
Lakewood Health SystemStaples, MN, CCN 24Z329 Hospital Corporate Director Aug 7, 2017
Lakewood Health SystemStaples, MN, CCN 245420A Skilled nursing facility Corporate Director Aug 7, 2017
Lakewood Health System Home Care and HospiceStaples, MN, CCN 247124 Home health agency Corporate Director Aug 7, 2017
Lakewood Health SystemStaples, MN, CCN 241559 Hospice Corporate Director Aug 7, 2017
Lakewood Health System BrowervilleBrowerville, MN, CCN 243423 Rural health clinic Corporate Director Aug 7, 2017
Lakewood ClinicStaples, MN, CCN 243422 Rural health clinic Corporate Director Aug 7, 2017
Lakewood Clinic-BrowervilleEagle Bend, MN, CCN 243421 Rural health clinic Corporate Director Aug 7, 2017
Lakewood Clinic-MotleyMotley, MN, CCN 243431 Rural health clinic Corporate Director Aug 7, 2017
Lakewood Clinic-PillagerPillager, MN, CCN 243436 Rural health clinic Corporate Director Aug 7, 2017

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1972913119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOECK",
        "first_name": "KAITLYN",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "59528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "PELOWSKI",
            "middle_name": "ROSE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staples, MN

Sources for this page

Verify at the official NPI Registry.