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

Kelsey Widmyer Israelson, PA

Individual provider Physician Assistant · NPI 1003507419

Kelsey Widmyer Israelson, PA is a Physician Assistant in St Louis Park, Minnesota. Qualified in 2024, 2 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
2
Licensed in
MN
In the registry since
2023
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone: (952) 883-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1320 W Lombard St, Davenport, IA 52804-2029 — (563) 333-5827
  • 2500 Como Ave, Saint Paul, MN 55108-1460 — (952) 853-8800

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 15273 (MN)

Record details

NPI number1003507419
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 17, 2023
Last updated in NPPESJune 2, 2025
Certification dateJune 2, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

Other providers in St Louis Park