1669983342 NPI number — MR. BRIAN KASEL PA-C

Table of content: MR. BRIAN KASEL PA-C (NPI 1669983342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669983342 NPI number — MR. BRIAN KASEL PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KASEL
Provider First Name:
BRIAN
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669983342
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6452 CITY WEST PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDEN PRAIRIE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55344-3245
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-999-0333
Provider Business Mailing Address Fax Number:
952-300-2558

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1103 W BURNSVILLE PKWY STE 110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURNSVILLE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55337-5828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-427-0951
Provider Business Practice Location Address Fax Number:
612-471-0364
Provider Enumeration Date:
10/20/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  12504 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1144773 . This is a "NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS" identifier . This identifiers is of the category "OTHER".




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