KELLAN KONNOR DOBERSTEIN MD
NPI 1235076605
Student in an Organized Health Care Education/Training Program in Saint Paul, MN

Q: What is Kellan Doberstein's NPI number?

The NPI number for Kellan Doberstein is 1235076605. It was assigned to this individual provider in the NPPES registry on May 2, 2026.

Q: What is Kellan Doberstein's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Kellan Doberstein was last updated on May 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 02, 2026PECOS Enrolled

640 JACKSON ST, SAINT PAUL, MN 55101(651) 254-3456 Get Directions Write a Review

NPPES record last updated: May 2, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Kellan Konnor Doberstein Md NPPES

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

KELLAN KONNOR DOBERSTEIN MD (NPI 1235076605) is an individual student in an organized health care education/training program in Saint Paul, Minnesota and active in the NPI registry since May 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235076605

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameKELLAN KONNOR DOBERSTEINCredential: MD

Location Address640 JACKSON STSaint Paul, MN 55101-2595

Mailing Address640 Jackson StSaint Paul, MN 55101-2595

Phone(651) 254-3456

Sole ProprietorNo

Enumeration DateMay 2, 2026

NPPES CertifiedMay 2, 2026

✔ NPI 1235076605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

640 JACKSON ST, Saint Paul, MN 55101

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kellan Konnor Doberstein Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

WOJCIECH KRASZKIEWICZ M.D.

Internal Medicine