Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Alyssa Kettler

Individual provider Pediatric Emergency Medicine (Emergency Medicine) Physician · NPI 1518594092

Alyssa Kettler is an Emergency Medicine in Saint Paul, Minnesota. Graduated from Western Michigan Un Homer Stryker School of Med in 2020, 6 years ago. Works from 3 locations. Licensed in California and Minnesota.

Years since qualifying
6
Trained at
Western Michigan Un Homer Stryker School of Med
Licensed in
CA, MN
In the registry since
2020
Specialties on file
2

Practice location Address checks out

640 Jackson St # T
Saint Paul, MN 55101-2502
Phone: (651) 254-3456
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1000 W Carson St, Torrance, CA 90502-2004 — (310) 222-2345
  • 927 Churchill St W, Stillwater, MN 55082-6605 — (651) 430-4529

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 78809 (MN)
Pediatric Emergency Medicine (Emergency Medicine) Physician Taxonomy 207PP0204X · Licence A187029 (CA)

Record details

NPI number1518594092
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 25, 2020
Last updated in NPPESAugust 18, 2025
Certification dateAugust 18, 2025
Mailing address1000 W Carson St, Torrance, CA 90502-2004

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolWESTERN MICHIGAN UN HOMER STRYKER SCHOOL OF MED
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Saint Paul