PRIME FAMILY MEDICAL CLINIC
NPI 1306445853
Nurse Practitioner - Family in North Oaks, MN
About Prime Family Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRIME FAMILY MEDICAL CLINIC (NPI 1306445853) is a healthcare organization registered as a family in North Oaks, Minnesota and active in the NPI registry since October 2020. The organization lists Mindy Lee Kang, Ceo/np, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Prime Family Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Prime Family Medical Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
North Oaks, MN 55127
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Prime Family Medical Clinic's NPI number?
The NPI number for Prime Family Medical Clinic is 1306445853. It was assigned to this organization in the NPPES registry on October 25, 2020.
Where is Prime Family Medical Clinic located?
Prime Family Medical Clinic is located at 200 Village Center Dr Ste 800, North Oaks, MN 55127. The listed phone number is (651) 219-8583.
What is Prime Family Medical Clinic's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Prime Family Medical Clinic enrolled in Medicare?
Yes. Prime Family Medical Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Prime Family Medical Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Prime Family Medical Clinic. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Prime Family Medical Clinic was last updated on May 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Prime Family Medical Clinic · NPI 1306445853
Family organization in North Oaks, Minnesota. Organization record, active in the CMS NPPES registry since October 25, 2020.
## Identity
- **NPI:** 1306445853 (Entity type: Organization)
- **Enumerated:** October 25, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Mindy Kang, CEO/NP
## Practice location
- **Address:** 200 VILLAGE CENTER DR STE 800, North Oaks, MN 55127-7092
- **Phone:** (651) 219-8583 · **Fax:** (651) 800-9859
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 22, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1306445853) · Data from the CMS NPPES public registry.