NPIMap

Individual provider Active NPI

Kathryn Nicole Kuske, PA-C

  • Medical Physician Assistant
  • Shakopee, MN
National Provider Identifier
1982919718
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10748 Issued in MN
Practice address
1415 Saint Francis Ave
Shakopee, MN 55379-3374
Phone
(952) 993-7750
Fax
(952) 993-7835
NPI assigned
Aug 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10748 MN Primary

Addresses

Primary practice location

1415 Saint Francis Ave
Shakopee, MN 55379-3374

Mailing address

1415 Saint Francis Ave
Shakopee, MN 55379-3374
Phone (952) 993-7750

Other names 1

  • Kathryn Nicole Sachwitz 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
I20101023000054 MN Practitioner - Physician Assistant 1153514013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

4670 Park Nicollet Ave SE
Prior Lake, MN 55372-4119
Phone (952) 993-7750

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053
  • St Francis Regional Medical Center Hospital, Shakopee, MN, CCN 240104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10748MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Sep 1, 2010 Accepting new patients
Park Nicollet Clinic CurrentSince Sep 1, 2010 Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

4670 Park Nicollet Ave SE
Prior Lake, MN 55372
Phone (952) 993-7750

1415 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 993-7750

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1982919718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 SAINT FRANCIS AVE",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553793374",
            "telephone_number": "952-993-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 SAINT FRANCIS AVE",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553793374",
            "telephone_number": "952-993-7750",
            "fax_number": "952-993-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSKE",
        "first_name": "KATHRYN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "10748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "SACHWITZ",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.