Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly L Dziedzic, PA-C

Individual provider Physician Assistant · NPI 1568437879

Kelly L Dziedzic, PA-C is a Physician Assistant in Burnsville, Minnesota. Qualified in 2002, 24 years ago. Works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
24
Licensed in
MN
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1000 W 140th St Unit 201
Burnsville, MN 55337-4833
Phone: (952) 808-3000
Fax: (952) 808-3001
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2090 Woodwinds Dr, Woodbury, MN 55125-2522 — (651) 968-5801

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9792 (MN)

Record details

NPI number1568437879
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 21, 2006
Last updated in NPPESJanuary 2, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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