Individual provider Active NPI

Kamiab Delfanian, MD

  • Internal Medicine Physician
  • Saint Cloud, MN
National Provider Identifier
1043229438
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
41861 Issued in MN
Practice address
1900 Centracare Cir
Suite 2400
Saint Cloud, MN 56303-5000
Phone
(320) 229-5099
Fax
(320) 229-5171
NPI assigned
Aug 5, 2006
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2958 WI
Internal Medicine Physician 207R00000X 41861 MN Primary

Addresses

Primary practice location

1900 Centracare Cir
Suite 2400
Saint Cloud, MN 56303-5000

Mailing address

1900 Centracare Cir
Suite 2400
Saint Cloud, MN 56303-5000
Phone (320) 229-5099

Other practice location 1

205 Parker St
Boscobel, WI 53805-1642
Phone (608) 375-4112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4905SDMDPharmacist
2958WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Sibley Medical Center Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

15650 Cedar Ave
Apple Valley, MN 55124
Phone (952) 997-4100

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

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

6545 France Ave S
Ste 150
Edina, MN 55435
Phone (952) 848-5600

3809 42nd Ave S
Minneapolis, MN 55406
Phone (612) 407-7213

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

2155 Ford Pkwy
Ste A
Saint Paul, MN 55116
Phone (651) 696-5000

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: kdelfanian804944@direct.gundersenhealth.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1043229438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR",
            "address_2": "SUITE 2400",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-5099",
            "fax_number": "320-229-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR",
            "address_2": "SUITE 2400",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-5099",
            "fax_number": "320-229-5171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Parker St",
            "address_purpose": "LOCATION",
            "city": "Boscobel",
            "state": "WI",
            "postal_code": "538051642",
            "country_code": "US",
            "telephone_number": "608-375-4112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELFANIAN",
        "first_name": "KAMIAB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "2958",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "41861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.