JANELLE L KYLLO BOUCHIE PA-C
NPI 1366716102
Physician Assistant in Detroit Lakes, MN

Q: What is Janelle Kyllo Bouchie's NPI number?

The NPI number for Janelle Kyllo Bouchie is 1366716102. It was assigned to this individual provider in the NPPES registry on February 24, 2012.

Q: What is Janelle Kyllo Bouchie's specialty?

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

Active since February 24, 2012PECOS EnrolledAccepts Medicare Assignment

1027 WASHINGTON AVE, DETROIT LAKES, MN 56501(218) 847-5611 Get Directions Write a Review

NPPES record last updated: November 10, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 10, 2021, Oct 11, 2018 (2 updates tracked since 2018).

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About Janelle L Kyllo Bouchie Pa-c NPPES

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

JANELLE L KYLLO BOUCHIE PA-C (NPI 1366716102) is an individual physician assistant in Detroit Lakes, Minnesota, licensed in Minnesota (12809) and active in the NPI registry since February 2012. She is enrolled in Medicare PECOS, is affiliated with Essentia Health St Marys - Detroit Lakes, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1366716102

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameJANELLE L KYLLO BOUCHIECredential: PA-C

Location Address1027 WASHINGTON AVEDetroit Lakes, MN 56501-3409

Mailing Address1702 University Dr SFargo, ND 58103-4940

Phone(218) 847-5611

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateFebruary 24, 2012

Last NPPES UpdateNovember 10, 20212 updates tracked since enumeration

NPPES CertifiedNovember 10, 2021

✔ NPI 1366716102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MN · 12809

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.

Also ListedOccupational Therapist · PediatricsTaxonomy 225XP0200X · License OT-1120 (ID)

1027 WASHINGTON AVE, Detroit Lakes, MN 56501

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

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

Janelle L Kyllo Bouchie Pa-c 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 ID143573311

PECOS Enrollment IDI20181106000177

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

103 services95 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

67 services65 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

33 services30 patients

Hospital Affiliations CMS Care Compare 2

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

Essentia Health St Marys - Detroit Lakes

Acute Care Hospitals · Detroit Lakes, MN

OwnershipVoluntary non-profit - Church

CMS Certification Number240101

Location1027 Washington AveDetroit Lakes, MN 56501 · Becker County

Birthing friendly

St Josephs Area Health Services

Critical Access Hospitals · Park Rapids, MN

OwnershipVoluntary non-profit - Private

CMS Certification Number241380

Location600 Pleasant AvenuePark Rapids, MN 56470 · Hubbard County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56501 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.

MELISSA M HOFFMAN

Occupational Therapist