Individual provider Active NPI

Danya M. Kiydal, M.D.

  • Occupational Medicine Physician
  • Rochester, MN
National Provider Identifier
1063947729
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
76912 Issued in MN
Practice address
210 9TH St SE Ste 1
Rochester, MN 55904-6400
Phone
(507) 292-7144
NPI assigned
May 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 01086744A IN
Student in an Organized Health Care Education/Training Program 390200000X
Occupational Medicine Physician 2083X0100X 76912 MN Primary

Addresses

Primary practice location

210 9TH St SE Ste 1
Rochester, MN 55904-6400

Mailing address

4501 Acorn LN NW
Rochester, MN 55901-7798
Phone (352) 653-8683

Other names 1

  • Danya Loutfi Former name

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
I20240617001065 MN Practitioner - Preventive Medicine 7517234982 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76912MNMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Olmsted Medical Center CurrentSince Jul 5, 2024 Accepting new patients
Olmsted Medical Center CurrentSince Jul 5, 2024 Accepting new patients

Locations

210 9th St SE
Rochester, MN 55904
Phone (507) 529-6616

1650 4th St SE
Rochester, MN 55904
Phone (507) 285-8485

210 9th St SE
Ste 1
Rochester, MN 55904
Phone (507) 292-7144

Interoperability endpoints

  • Direct secure messaging: dkiydal24023@direct.olmmed.org
  • Direct secure messaging: dkiydal13446@middlesexhealthprd.direct-ci.com

Organizations & group practices 2

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1063947729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 ACORN LN NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559017798",
            "telephone_number": "352-653-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 9TH ST SE STE 1",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046400",
            "telephone_number": "507-292-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIYDAL",
        "first_name": "DANYA",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01086744A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "MN",
            "license": "76912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANYA",
            "last_name": "LOUTFI",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.