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

Kaeli Mikel Demarco

Individual provider Physician Assistant · NPI 1609464734

Kaeli Mikel Demarco is a Physician Assistant in Plymouth, Minnesota. Qualified in 2022, 4 years ago. Practices with Minneapolis Radiology Associates Ltd, a 44-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

2800 Campus Dr Ste 20
Plymouth, MN 55441-2669
Phone: (763) 236-6000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 — (763) 236-6000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14230 (MN)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1609464734
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 5, 2021
Last updated in NPPESDecember 13, 2024
Certification dateDecember 13, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Minneapolis Radiology Associates Ltd — 44 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Plymouth