KATELYN CORINE KRUEGER (PA-C) – Physician Assistant, NPI 1104493568

KATELYN CORINE KRUEGER (PA-C) is a healthcare provider. based in New london, Minnesota. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. The NPI Number for KATELYN CORINE KRUEGER (PA-C) is 1104493568

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
KATELYN CORINE KRUEGER (PA-C)
NPI
1104493568
Phone
(320) 760-5675
Address
20819 HIGHWAY 23 NE
Enumeration Date
4 June 2021
Last Update Date
4 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3206345157
Graduation Year
2021 (5 years ago)
PAC ID
2769888668
Group Practice PAC ID
5294789194
Professional Enrollment ID
I20210901000318
Address ID
MN563341518GL417XXSXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:5State licenses:0Digital endpointsOther names

4,031 PHYSICIAN ASSISTANT in MN

Provider Addresses for KATELYN CORINE KRUEGER (PA-C)

  • 20819 HIGHWAY 23 NE

    NEW LONDON, MN 562739402

    Phone: (320) 760-5675

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-09-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210901000318IPhysician AssistantMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths35757$0
17000Destruction of precancer skin growth, 1 growth9374$0
99213Established patient office or other outpatient visit, 20-29 minutes8271$0
11102Biopsy of related skin growth, first growth7773$0
99203New patient office or other outpatient visit, 30-44 minutes7373$0
View full utilization report →

Insurance plans in this area (ZIP 56273)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294789194View full group profile
NameSpecialtyState
Nurse PractitionerMN
O P T O M E T R YMN
General Practice, Emergency MedicineMN
Family PracticeMN
Ophthalmology, General PracticeMN
Certified Nurse Midwife (Cnm)SD
Nurse PractitionerMN
O B S T E T R I C S/ G Y N E C O L O G YMN
Diagnostic RadiologyND
Nurse PractitionerSD

Reviews

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Frequently asked questions

Where can patients find KATELYN CORINE KRUEGER (PA-C)'s NPI?
You can confirm KATELYN CORINE KRUEGER (PA-C) with NPI 1104493568; it appears in the national provider directory.
Is KATELYN CORINE KRUEGER (PA-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is KATELYN CORINE KRUEGER (PA-C)?
The page reflects Physician Assistant for KATELYN CORINE KRUEGER (PA-C). Clinical services aligned with this taxonomy classification.
Where is KATELYN CORINE KRUEGER (PA-C)'s primary listing?
We display New London, Minnesota because that is what the record indicates for KATELYN CORINE KRUEGER (PA-C).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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