KATHLEEN ELIZABETH PENGELLY CNP
NPI 1760956668
Registered Nurse - Psychiatric/Mental Health, Adult in Saint Paul, MN

Q: What is the provider's specialty?

The provider's specialty is Registered Nurse with taxonomy code 163WP0809X and a focus in Psychiatric/Mental Health, Adult.

Active since January 15, 2019PECOS EnrolledAccepts Medicare Assignment

762 TRANSFER RD STE 21, SAINT PAUL, MN 55114(651) 659-2900(651) 645-7307 Get Directions Write a Review

NPPES record last updated: August 15, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 15, 2019, Jan 15, 2019 (2 updates tracked since 2019).

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About Kathleen Elizabeth Pengelly Cnp NPPES

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

KATHLEEN ELIZABETH PENGELLY CNP (NPI 1760956668) is an individual psychiatric/mental health, adult provider in Saint Paul, Minnesota, licensed in Minnesota (138239-0) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1760956668

Entity TypeIndividualFemale

Primary Taxonomy163WP0809X

Provider Legal NameKATHLEEN ELIZABETH PENGELLYCredential: CNP

Location Address762 TRANSFER RD STE 21Saint Paul, MN 55114-1489

Mailing Address762 Transfer Rd Ste 21Saint Paul, MN 55114-1489 · (651) 955-3397 · Fax (651) 645-7307

Phone(651) 659-2900

Fax(651) 645-7307

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateJanuary 15, 2019

Last NPPES UpdateAugust 15, 20192 updates tracked since enumeration

✔ NPI 1760956668 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRegistered Nurse · Psychiatric/Mental Health, AdultNursing Service Providers

Taxonomy Code163WP0809X

License✔ Licensed in MN · 138239-0

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License 6667 (MN)

762 TRANSFER RD STE 21, Saint Paul, MN 55114

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Secondary Practice Locations 2

Location 115420 Founders LnApple Valley, MN 55124-6076 · Phone (651) 659-2900 · Fax (952) 431-5842

Location 2501 Highway 13 E Ste 116Burnsville, MN 55337-2877 · Phone (651) 681-9366 · Fax (651) 681-9317

Accepted Insurance

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

Kathleen Elizabeth Pengelly Cnp 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 ID5193053411

PECOS Enrollment IDI20190826000339

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

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

66 services12 patients

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.

YVETTE ANDERSON

Counselor (Professional)