1. Home
  2. Directory
  3. Minnesota
  4. St Louis Park
  5. Physician Assistant
  6. NPI Profile

KELSEY WIDMYER ISRAELSON PA
NPI 1003507419
Physician Assistant in St Louis Park, MN

Active since May 17, 2023PECOS EnrolledAccepts Medicare Assignment
3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416(952) 883-1000 Get Directions Write a Review

NPPES record last updated: June 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 2, 2025, May 17, 2023 (2 updates tracked since 2023).

About Kelsey Widmyer Israelson Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELSEY WIDMYER ISRAELSON PA (NPI 1003507419) is an individual physician assistant in St Louis Park, Minnesota, licensed in Minnesota (15273) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS, is affiliated with Park Nicollet Methodist Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1003507419
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKELSEY WIDMYER ISRAELSONCredential: PA
Location Address3850 PARK NICOLLET BLVDSt Louis Park, MN 55416-2527
Mailing Address8170 33rd Ave S # Ms 21110qBloomington, MN 55425-4516
Phone(952) 883-1000
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateMay 17, 2023
Last NPPES UpdateJune 2, 20252 updates tracked since enumeration
NPPES CertifiedJune 2, 2025
✔ NPI 1003507419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MN · 15273
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
3850 PARK NICOLLET BLVD, St Louis Park, MN 55416
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11320 W Lombard StDavenport, IA 52804-2029 · Phone (563) 333-5827
Location 22500 Como AveSaint Paul, MN 55108-1460 · Phone (952) 853-8800 · Fax (651) 641-6205

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelsey Widmyer Israelson Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143747774
PECOS Enrollment IDI20250507002568
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Park Nicollet Methodist Hospital

Acute Care Hospitals · Saint Louis Park, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240053
Location6500 Excelsior BlvdSaint Louis Park, MN 55426 · Hennepin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55416 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELISABETH JEAN MCCLEAN MD
Family Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 883-1000
AMY VANDENBERG PA-C
Physician Assistant
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 883-1000
KARI MILLER
Family Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 993-3512
SARAH EVERT
Internal Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 993-3025
DR. WAYNE D LIEBHARD M.D.
Family Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 993-3025
PATRICK MUELLER
Pediatrics
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 993-3298
PARK NICOLLET HEALTH CARE PRODUCTS
Durable Medical Equipment & Medical Supplies
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 993-1330
KRISTI TROSTEL
Internal Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 993-5041

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelsey Israelson's NPI number?

The NPI number for Kelsey Israelson is 1003507419. It was assigned to this individual provider in the NPPES registry on May 17, 2023.

Where is Kelsey Israelson located?

Kelsey Israelson practices at 3850 Park Nicollet Blvd, St Louis Park, MN 55416. The listed phone number is (952) 883-1000.

What is Kelsey Israelson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kelsey Israelson enrolled in Medicare?

Yes. Kelsey Israelson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Kelsey Israelson affiliated with any hospitals?

According to CMS data, Kelsey Israelson is affiliated with Park Nicollet Methodist Hospital.

When was this NPI record last updated?

The NPPES record for Kelsey Israelson was last updated on June 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.