NPIMap

Individual provider Active NPI

Karla Susan Rosenman, MD

  • Dermatology Physician
  • St Louis Park, MN
National Provider Identifier
1013943505
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
51635 Issued in MN
Practice address
3800 Park Nicollet Blvd
Dermatology 4TH Floor
St Louis Park, MN 55416-2527
Phone
(952) 993-3821
NPI assigned
Jun 25, 2006
Last updated
Apr 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 51635 MN Primary
Dermatopathology Physician 207ND0900X 51635 MN

Addresses

Primary practice location

3800 Park Nicollet Blvd
Dermatology 4TH Floor
St Louis Park, MN 55416-2527

Mailing address

8170 33Rd Ave S
PO Box 1309 Mail Stop 21110Q
Minneapolis, MN 55425-4516

Other names 1

  • Karla Susan Draft Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090402000241 MN Practitioner - Dermatology 7517900400 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Indiana University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700

300 Lake Dr E
Chanhassen, MN 55317-9302
Phone (952) 993-4300

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions24
Removal or shaving of skin growth29
Skin biopsy23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51635MNMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Jan 31, 2009 Accepting new patients
Park Nicollet Clinic CurrentSince Jan 31, 2009 Accepting new patients
Group Health, Inc. Current Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Vanguard Dermatology Past Accepting new patients
New York University Medical Center Dermatology Past Accepting new patients
Vanguard Dermatology PC PastSince Nov 10, 2017 Accepting new patients
Nyumc Dermatopathology Unit Dermatopathology Past Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8170 33rd Ave S
Stop 21110Q
Minneapolis, MN 55425

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 993-1000

3800 Park Nicollet Blvd
Fl 4
St Louis Park, MN 55416
Phone (952) 993-3123

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1013943505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "PO BOX 1309 MAIL STOP 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "address_2": "DERMATOLOGY 4TH FLOOR",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-993-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENMAN",
        "first_name": "KARLA",
        "middle_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "51635",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "MN",
            "license": "51635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARLA",
            "last_name": "DRAFT",
            "middle_name": "SUSAN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.