NPIMap

Individual provider Active NPI

Robert Lukken Imel, DO

  • Pulmonary Disease Physician
  • Saint Cloud, MN
National Provider Identifier
1154850592
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
74060 Issued in MN
Practice address
1200 6TH Ave N
Saint Cloud, MN 56303-2736
Phone
(320) 240-2207
NPI assigned
Jun 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 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
Pulmonary Disease Physician 207RP1001X 74060 MN Primary

Addresses

Primary practice location

1200 6TH Ave N
Saint Cloud, MN 56303-2736

Mailing address

1200 6TH Ave N
Saint Cloud, MN 56303-2735

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
I20230527000198 MN Practitioner - Internal MedicinePractitioner - Pulmonary Disease 2062764848 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Oklahoma State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Practice addresses (Care Compare)

101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000

1200 6TH Ave N
St Cloud, MN 56303-2735
Phone (320) 252-5131

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036
  • Centracare- Rice Memorial Hospital Hospital, Willmar, MN, CCN 240088
  • Alomere Health Hospital, Alexandria, MN, CCN 240030
  • St Gabriels Hospital Hospital, Little Falls, MN, CCN 241370
  • Centracare - Redwood Hospital, Redwood Falls, MN, CCN 241351

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince May 1, 2023 Accepting new patients
Medical University of Ohio at Toledo Current Accepting new patients
St. Cloud Hospital CurrentSince Dec 1, 2023 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Dec 1, 2023 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Dec 1, 2023 Accepting new patients
St. Cloud Hospital CurrentSince Dec 1, 2023 Accepting new patients
St. Cloud Hospital Current Accepting new patients
Centracare Clinic CurrentSince May 1, 2023 Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

3000 Arlington Ave
#1150
Toledo, OH 43614
Phone (419) 383-4480

Interoperability endpoints

  • Direct secure messaging: rimel690161@direct.centracare.com
  • Direct secure messaging: rimel38396@direct.utoledo.edu

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1154850592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032736",
            "telephone_number": "320-240-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMEL",
        "first_name": "ROBERT",
        "middle_name": "LUKKEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "74060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.