Individual provider Active NPI

Katherine Grace Shafto, MD

  • Internal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1063615474
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53503 Issued in MN
Practice address
715 S 8TH St
Minneapolis, MN 55404-7530
Phone
(612) 873-6963
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 53503 MN
Internal Medicine Physician 207R00000X 53503 MN Primary

Addresses

Primary practice location

715 S 8TH St
Minneapolis, MN 55404-7530

Mailing address

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000

Other names 1

  • Katherine Grace Venable Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101116001103 MN Practitioner - Internal MedicinePractitioner - Pediatric Medicine 1254526247 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
74.5
Promoting interoperability
100
Improvement activities
40
Cost
72.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53503MNMDPediatrics Physician
104848MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Jul 25, 2010 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients
Fairview Health Services Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Aug 3, 2019 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Aug 3, 2019 Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2012 Accepting new patients
Fairview Health Services CurrentSince Jul 15, 2012 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

701 Park Ave
#741
Minneapolis, MN 55415

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

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

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

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

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

715 S 8th St
Minneapolis, MN 55404
Phone (612) 873-6010

420 Delaware St SE
#741
Minneapolis, MN 55455
Phone (612) 624-8984

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

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1063615474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S 8TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554047530",
            "telephone_number": "612-873-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFTO",
        "first_name": "KATHERINE",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "53503",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "53503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "VENABLE",
            "middle_name": "GRACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.