Individual provider Active NPI

John P Knoedler Jr., MD

  • Diagnostic Radiology Physician
  • Roseville, MN
National Provider Identifier
1023097078
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
24320 Issued in MN
Practice address
2355 Highway 36 W
Ste 100
Roseville, MN 55113-3905
Phone
(651) 292-2000
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 24320 MN Primary

Addresses

Primary practice location

2355 Highway 36 W
Ste 100
Roseville, MN 55113-3905

Mailing address

2355 Highway 36 W
Ste 100
Roseville, MN 55113-3905
Phone (651) 292-2000

Other identifiers 1

IdentifierTypeStateIssuer
574063100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040903000182 WI Practitioner - Diagnostic Radiology 7911811609 Reassigns benefits to 1 organization
I20080603000224 MN Practitioner - Diagnostic Radiology 7911811609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Minnesota Medical School, 1977
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

166 4TH St E
St Paul, MN 55101-1421

168 4TH St E
St Paul, MN 55101-1421

190 E 5TH St
Suite 250
St Paul, MN 55101-1623

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Range Regional Health Services CurrentSince Jan 1, 2025 Accepting new patients
Park Nicollet Clinic CurrentSince Dec 31, 2022 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Fairview Clinics CurrentSince Dec 31, 2022 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jan 20, 2025 Accepting new patients
Range Regional Health Services CurrentSince Jan 1, 2025 Accepting new patients
Allina Health System CurrentSince Jun 1, 2016 Accepting new patients
William Noyes, MD PC CurrentSince Jan 2, 2026 Accepting new patients
Suburban Imaging, LLC CurrentSince Mar 1, 2019 Accepting new patients
Fairview Health Services CurrentSince Jul 15, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Feb 1, 2025 Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
Altru Health System CurrentSince Aug 15, 2011 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Feb 1, 2025 Accepting new patients
Allina Health System Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jul 15, 2019 Accepting new patients
Allina Health System Current Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Altru Health System Current Accepting new patients
Altru Health System CurrentSince Aug 15, 2011 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jul 15, 2019 Accepting new patients
Altru Health System CurrentSince Nov 1, 2011 Accepting new patients
Park Nicollet Clinic CurrentSince Dec 31, 2022 Accepting new patients
Fairview Clinics CurrentSince Dec 31, 2022 Accepting new patients
Lac Qui Parle Clinic of Madison Inc CurrentSince Dec 18, 2023 Accepting new patients
The Duluth Clinic LTD CurrentSince Jan 20, 2025 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Madison Healthcare Services CurrentSince Apr 14, 2024 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 15, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
Range Regional Health Services Current Accepting new patients
Midwest Radiology Outpatient Imaging, LLC Diagnostic Radiology CurrentSince Jan 1, 2000 Accepting new patients
Midwest Radiology, PA Diagnostic Radiology CurrentSince Jul 1, 1999 Accepting new patients
Consulting Radiologists, LTD Diagnostic Radiology PastSince Mar 1, 2019 Accepting new patients
Allina Health System Past Accepting new patients

Locations (25 of 59)

515 College St
Cedar Falls, IA 50613
Phone (319) 268-3000

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

14000 Nicollet Ave
Ste 204
Burnsville, MN 55337
Phone (952) 898-2333

323 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9200

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 125
Edina, MN 55435
Phone (952) 405-2777

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

1010 S Birch Ave
Hallock, MN 56728
Phone (218) 843-3612

1175 Nininger Rd
Hastings, MN 55033
Phone (651) 404-1000

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

3605 Mayfair Ave
Hibbing, MN 55746
Phone (218) 262-3441

8650 Hudson Blvd N
Ste 130
Lake Elmo, MN 55042
Phone (651) 730-4145

900 2nd Ave
Madison, MN 56256
Phone (320) 598-7536

820 3rd Ave
Madison, MN 56256
Phone (320) 598-3552

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

12000 Elm Creek Blvd N
Ste 310
Maple Grove, MN 55369
Phone (763) 416-7888

2945 Hazelwood St
Ste 110
Maplewood, MN 55109

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

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

6545 France Ave S
Ste 115
Minneapolis, MN 55435
Phone (952) 893-1997

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

Organizations & group practices 42

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

View all 42

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1023097078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W",
            "address_2": "STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W",
            "address_2": "STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOEDLER",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "24320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "574063100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.