KAITLYN MELLESMOEN PA-C
NPI 1790451540
Physician Assistant in Edina, MN

Q: What is Kaitlyn Mellesmoen's NPI number?

The NPI number for Kaitlyn Mellesmoen is 1790451540. It was assigned to this individual provider in the NPPES registry on August 20, 2021. The provider is also known as Kaitlyn Daggett.

Q: What is Kaitlyn Mellesmoen's specialty?

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

Active since August 20, 2021PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

7400 FRANCE AVE S STE 100, EDINA, MN 55435(763) 537-6000 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 19, 2025, Aug 20, 2021 (2 updates tracked since 2021).

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About Kaitlyn Mellesmoen Pa-c NPPES

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

KAITLYN MELLESMOEN PA-C (NPI 1790451540) is an individual physician assistant in Edina, Minnesota, licensed in Minnesota (13559) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1790451540

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKAITLYN MELLESMOENCredential: PA-C

Location Address7400 FRANCE AVE S STE 100Edina, MN 55435-4738

Mailing Address2104 Northdale Blvd Nw Ste 220Coon Rapids, MN 55433-3046 · (763) 537-6000 · Fax (763) 537-6666

Phone(763) 537-6000

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateAugust 20, 2021

Last NPPES UpdateNovember 19, 20252 updates tracked since enumeration

NPPES CertifiedNovember 19, 2025

✔ NPI 1790451540 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MN · 13559

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.

7400 FRANCE AVE S STE 100, Edina, MN 55435

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Other Names 1

Former Name (1)Kaitlyn Daggett

Secondary Practice Locations 2

Location 12104 Northdale Blvd NW Ste 220Coon Rapids, MN 55433-3046 · Phone (763) 537-6000 · Fax (763) 537-6666

Location 27390 France Ave SEdina, MN 55435-4500 · Phone (763) 537-6000

Other Identifiers 2

Other1166361Nccpa

Other13559MN · Mn Board Of Medical Practice Pa Licensure

Accepted Insurance

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

Kaitlyn Mellesmoen 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 ID1850797937

PECOS Enrollment IDI20210915002238

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 5

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.

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.

215 services129 patients

Electronic analysis reprogramming and refill of spinal canal drug infusion pump 62369

This procedure involves checking and adjusting a small device placed under your skin that delivers medication directly to your spinal canal. The device is reprogrammed as needed and the medicine is refilled to manage your pain effectively.

203 services127 patients

Compounded drug, not otherwise classified J7999

A compounded drug is a personalized medication created to meet unique patient needs. If you can't take standard drugs due to allergies or need a specific dosage not commercially available, a pharmacist can mix ingredients to make a drug specifically for you.

197 services121 patients

Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms G0481

A definitive drug test is a detailed analysis used to identify specific drugs in your system. It uses advanced techniques, such as gc/ms and lc/ms, to detect and distinguish between different drugs, even those with similar structures.

165 services117 patients

Electronic analysis and reprogramming of spinal canal drug infusion pump 62368

This procedure involves the use of technology to assess and adjust a medication pump, implanted near the spine. The pump delivers precise doses of medication directly into the spinal canal to manage pain or spasticity. The reprogramming ensures optimal treatment.

35 services28 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55435 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

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Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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