Active NPI
Kathleen Lee Siedschlag, PA-C
- Medical Physician Assistant
- Oakes, ND
National Provider Identifier
1992925499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PAC0176
- Practice address
- 420 S 7TH St
Oakes, ND 58474-2024 - Phone
- (701) 742-3267
- Fax
- (701) 742-3201
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PAC0176 | ND | Primary |
Addresses
Primary practice location
420 S 7TH St
Oakes, ND 58474-2024
Mailing address
PO Box 50
Oakes, ND 58474-0050
Phone (701) 742-3267
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CF8850 | Other | ND | TRAVELERS MEDICARE |
| 71192 | Medicaid | ND | |
| 71277 | Medicaid | ND | |
| 970009837 | Other | ND | TRAVELERS MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAC0176 | ND | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Medical Center PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community Health Clinic/Center
- Lisbon, ND
- NPI 1124034509
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362528000000",
"number": "1992925499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 50",
"city": "OAKES",
"state": "ND",
"postal_code": "584740050",
"telephone_number": "701-742-3267",
"fax_number": "701-742-3201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 S 7TH ST",
"city": "OAKES",
"state": "ND",
"postal_code": "584742024",
"telephone_number": "701-742-3267",
"fax_number": "701-742-3201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEDSCHLAG",
"first_name": "KATHLEEN",
"middle_name": "LEE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2013-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "ND",
"license": "PAC0176",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRAVELERS MEDICARE",
"identifier": "CF8850",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "71192",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "71277",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRAVELERS MEDICARE",
"identifier": "970009837",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakes, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.