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

Tasha Kiberenge, PA

Individual provider Medical Physician Assistant · NPI 1669840757

Tasha Kiberenge, PA is a Physician Assistant in Minneapolis, Minnesota. Qualified in 2015, 11 years ago. Practices with Fairview Express Care, a 1,964-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
11
Licensed in
MN
In the registry since
2015
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

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone: (612) 672-7422
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 12085 (MN)

Record details

NPI number1669840757
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 8, 2015
Last updated in NPPESFebruary 24, 2022
Certification dateFebruary 24, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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