Kiley Buchanan
NPI 1457879678ActiveIndividual· Physician Assistant· Bloomington, MN
Physician Assistant with Park Nicollet Clinic and 1 other group, practicing in Bloomington, Minnesota. Enrolled in Medicare as practitioner - physician assistant.
Overview
| NPI | 1457879678 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Sep 7, 2017 |
| Last updated in NPPES | Jun 19, 2024 |
| Certified by provider | Jun 19, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 14934 | MN |
| Specialist/Technologist, Athletic Trainer | 2255A2300X | — | — |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (MN) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical groups
- Park Nicollet ClinicSt Louis Park, MN · 1,787 clinicians
- Tria Orthopaedic Center LLCWoodbury, MN · 515 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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