Individual provider Active NPI

Kyle Maurer, DO

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
National Provider Identifier
1053773671
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
68963 Issued in MN
Practice address
7595 Anagram Dr
Eden Prairie, MN 55344-7399
Phone
(612) 573-2200
Fax
(612) 573-2274
NPI assigned
Mar 23, 2016
Last updated
Jun 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X 68963 MN Primary

Addresses

Primary practice location

7595 Anagram Dr
Eden Prairie, MN 55344-7399

Mailing address

7595 Anagram Dr
Eden Prairie, MN 55344-7399
Phone (612) 573-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210416001117 MN Practitioner - Diagnostic Radiology 4981998549 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Lake Erie College of Osteopathic Medicine, Bradenton, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

15650 Cedar Ave
Apple Valley, MN 55124-7283
Phone (952) 997-4100

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

516 Delaware St SE
Minneapolis, MN 55455-0356
Phone (612) 625-4400

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68963MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jun 8, 2021 Accepting new patients
Fairview Health Services Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jun 8, 2021 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Clinics CurrentSince Jun 1, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Jun 1, 2021 Accepting new patients
Stevens Community Medical Center Inc. Current Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
St. Francis Regional Medical Center CurrentSince Jun 1, 2022 Accepting new patients
Allina Health System Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Stevens Community Medical Center Inc CurrentSince Jul 9, 2022 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 1, 2023 Accepting new patients
Mankato Clinic LTD Diagnostic Radiology CurrentSince Sep 1, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Stevens Community Medical Center Inc CurrentSince Jul 9, 2022 Accepting new patients
St Francis Regional Medical Center CurrentSince Jun 1, 2022 Accepting new patients
Noran Neurological Clinic P.a. CurrentSince Sep 1, 2021 Accepting new patients
Fairview Health Services CurrentSince Jun 1, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Jun 8, 2021 Accepting new patients
Fairview Express Care CurrentSince Jun 8, 2021 Accepting new patients
University of Minnesota Physicians CurrentSince Jun 8, 2021 Accepting new patients
University of Minnesota Pediatric Dental Clinic CurrentSince Jun 8, 2021 Accepting new patients
Fairview Express Care CurrentSince Jun 1, 2021 Accepting new patients
Consulting Radiologists, LTD Diagnostic Radiology PastSince Sep 1, 2021 Accepting new patients
Quest Diagnostics LLC Il PastSince Sep 1, 2021 Accepting new patients

Locations

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

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

111 Hundertmark Rd
Chaska, MN 55318
Phone (952) 361-2447

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

6525 France Ave S
Ste 110
Edina, MN 55435
Phone (952) 285-3720

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

1230 E Main St
Mankato, MN 56001
Phone (507) 389-8502

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2828 Chicago Ave
Ste 200
Minneapolis, MN 55407
Phone 61287910001502

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

3601 Minnesota Dr
Ste 200
Minneapolis, MN 55435
Phone (952) 992-5691

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

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

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

7505 Metro Blvd
Ste 400
Minneapolis, MN 55439
Phone 61257322002246

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

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

400 E 1st St
Morris, MN 56267
Phone (320) 589-1313

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Interoperability endpoints

  • Direct secure messaging: kmaurer650197@fairview.direct-ci.com
  • Direct secure messaging: kylep.maurer@xdr.hhchealthdirect.org

Organizations & group practices 29

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.

View all 29

Hospital & facility affiliations 5

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": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1053773671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7595 ANAGRAM DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447399",
            "telephone_number": "612-573-2200",
            "fax_number": "612-573-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7595 ANAGRAM DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447399",
            "telephone_number": "612-573-2200",
            "fax_number": "612-573-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURER",
        "first_name": "KYLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "68963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.