MRS. KELLY ANN BUCHTA MSW, LICSW
NPI 1114495827
Social Worker - Clinical in Pine City, MN
About Mrs. Kelly Ann Buchta Msw, Licsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KELLY ANN BUCHTA MSW, LICSW (NPI 1114495827) is an individual clinical provider in Pine City, Minnesota, licensed in Minnesota (24674) and active in the NPI registry since November 2018. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Kelly Ann Buchta Msw, Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kelly Buchta reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Saint Louis Park, MN 55416
- Reassigned Medicare billing, Minnesota enrollment
- 11 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55063 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Kelly Buchta's NPI number?
The NPI number for Kelly Buchta is 1114495827. It was assigned to this individual provider in the NPPES registry on November 12, 2018.
Where is Kelly Buchta located?
Kelly Buchta practices at 220 Railroad St SE, Pine City, MN 55063. The listed phone number is (320) 629-7600.
What is Kelly Buchta's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Kelly Buchta enrolled in Medicare?
Yes. Kelly Buchta is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kelly Buchta's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Buchta reassigns Medicare benefits to Elizabeth Wagner, Psyd, LP, Inc. (Saint Louis Park, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Buchta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Buchta accept?
Health plans from HealthPartners and Sanford Health Plan list Kelly Buchta as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kelly Buchta was last updated on November 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.
# Mrs. Kelly Ann Buchta, MSW, LICSW · NPI 1114495827
Clinical provider in Pine City, Minnesota. Individual provider, active in the CMS NPPES registry since November 12, 2018.
## Identity
- **NPI:** 1114495827 (Entity type: Individual)
- **Enumerated:** November 12, 2018
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 24674 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 220 RAILROAD ST SE, Pine City, MN 55063
- **Phone:** (320) 629-7600
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Elizabeth Wagner, Psyd, LP, Inc. (NPI 1740637818, Saint Louis Park, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 12, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1114495827) · Data from the CMS NPPES public registry.