NPIMap

Individual provider Active NPI

Heidi R Kimmel, PAC

  • Physician Assistant
  • Edina, MN
National Provider Identifier
1124085303
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9579 Issued in MN
Practice address
6363 France Ave S
Ste 525
Edina, MN 55435-2129
Phone
(952) 926-6489
Fax
(952) 926-6501
NPI assigned
Apr 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9579 MN Primary

Addresses

Primary practice location

6363 France Ave S
Ste 525
Edina, MN 55435-2129

Mailing address

733 Chicago Dr
Burnsville, MN 55306-6448
Phone (952) 892-0434

Other names 1

  • Heidi B Rietz 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
I20040116000315 MN Practitioner - Physician Assistant 2567363138 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Oct 26, 2009 Accepting new patients
Park Nicollet Clinic CurrentSince Apr 27, 2015 Accepting new patients
Fairview Clinics CurrentSince Oct 26, 2009 Accepting new patients
Park Nicollet Clinic CurrentSince Apr 27, 2015 Accepting new patients

Locations

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

600 W 98th St
Minneapolis, MN 55420
Phone (952) 881-2651

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

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

Interoperability endpoints

  • Direct secure messaging: hkimmel156790@direct.healthpartners.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 6

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": "1146268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1124085303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 CHICAGO DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553066448",
            "telephone_number": "952-892-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 FRANCE AVE S",
            "address_2": "STE 525",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352129",
            "telephone_number": "952-926-6489",
            "fax_number": "952-926-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEL",
        "first_name": "HEIDI",
        "middle_name": "R",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-29",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "RIETZ",
            "middle_name": "B",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.