Keith E Eidman, DO

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

42869 Issued in MN

Practice address

701 Park Ave
S5
Minneapolis, MN 55415-1623

Phone

(612) 347-5871

Fax

(612) 347-2003

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, TX2 enrollments

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 2

Specialty

Nephrology

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Intermed Consultants Dialysis PLLCGroup PAC ID 7012225105, 11 clinicians

Intermed Consultants,LTD.Group PAC ID 8022033372, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Cass Lake Dialysis Dialysis facility, Cass Lake, MN, CCN 242528
• DaVita Minneapolis Dialysis Unit Dialysis facility, Minneapolis, MN, CCN 242503
• M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078
• Cass Lake Indian Health Services Hospital Hospital, Cass Lake, MN, CCN 241358
• M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207
• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: keith.eidman@direct.davitaphysiciansolutions.com

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.

• Intermed Consultants Dialysis, PLLC

  • Nephrology Physician
  • Edina, MN
  • NPI 1376912857
  Medicare reassignment Care Compare group NPD
• Intermed Consultants,LTD.

  • Nephrology Physician
  • Edina, MN
  • NPI 1962596221
  Medicare reassignment Care Compare group NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment Care Compare group
• Department of Health & Human Services PHS IHS

  • Critical Access Hospital
  • Cass Lake, MN
  • NPI 1194754382

  TX

  Medicare reassignment NPD
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Fairview Health Services

  • Hospitalist Physician
  • Edina, MN
  • NPI 1770663031
  NPD
• Hennepin Faculty Associates

  • General Practice Physician
  • Minneapolis, MN
  • NPI 1063459485
  NPD (past)

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cass Lake, MN
  • NPI 1770548422

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Minneapolis, MN
  • NPI 1982668380

  Dialysis facility

  Care Compare affiliation Name & address match
• Department of Health & Human Services PHS IHS

  • Critical Access Hospital
  • Cass Lake, MN
  • NPI 1194754382
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1225199128
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1245217520
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1699752915
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1932260833
  Care Compare affiliation

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1174579437",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "address_2": "S5",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-347-5871",
            "fax_number": "612-347-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDMAN",
        "first_name": "KEITH",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MN",
            "license": "42869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman Vernon Eid, D.D.S.
• Kristin Marie Eide, D.O.
• Michael Eide
• Russell Eide, PA-C
• Jay Henry Eidem, PHARMD
• Siri TS Eidsmo
• Erin Eidsness, MD
• Andrea Eiesland, OTR
• Mark H Eikenberry, M.D.
• Eiko Mizushima Integrative OT LLC

• Nephrology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Nephrology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.