NPIMap

Individual provider Active NPI

Kruti Tripathi Shukla, M.D.

  • Emergency Medicine Physician
  • Bloomington, MN
National Provider Identifier
1114173259
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
54259 Issued in MN
Practice address
4300 Market Pte Dr Ste 100
Bloomington, MN 55435-5435
Phone
(952) 767-4574
NPI assigned
Aug 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 54259 MN Primary

Addresses

Primary practice location

4300 Market Pte Dr Ste 100
Bloomington, MN 55435-5435

Mailing address

7213 Fleetwood Dr
Edina, MN 55439-1811
Phone (914) 299-1474

Other identifiers 1

IdentifierTypeStateIssuer
07P00000XOtherMNMD NUMBER

Other names 1

  • Miss Kruti Harshavardhan Tripathi Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110621000544 MN Practitioner - Emergency Medicine 9739232448 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Missouri, Kansas City, School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-1313

919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105333MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Professional Association Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Jun 30, 2011 Accepting new patients
Fairview Health Services CurrentSince Jun 30, 2011 Accepting new patients
Emergency Physicians Professional Association CurrentSince Aug 1, 2024 Accepting new patients

Locations

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

4300 Marketpointe Dr
Ste 100
Minneapolis, MN 55435
Phone (952) 767-4574

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

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

Interoperability endpoints

  • Direct secure messaging: kshukla207467@fairview.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1114173259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7213 FLEETWOOD DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554391811",
            "telephone_number": "914-299-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARKET PTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-767-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "KRUTI",
        "middle_name": "TRIPATHI",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-08",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "54259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD NUMBER",
            "identifier": "07P00000X",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRUTI",
            "last_name": "TRIPATHI",
            "middle_name": "HARSHAVARDHAN",
            "prefix": "MISS",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.