Kyle Erick Rudningen, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

70700 Issued in MN

Practice address

1900 Centracare Cir Ste 2575
Saint Cloud, MN 56303-5000

Phone

(320) 229-4924

Fax

(320) 229-4971

NPI assigned

Jul 23, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

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

Specialty

Dermatology

Education

University of North Dakota School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Skin Specialists LTDGroup PAC ID 0446558993, 15 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• United Skin Specialists, LTD PC

  • Procedural Dermatology Physician
  • Edina, MN
  • NPI 1861861759
  Medicare reassignment Care Compare group NPD
• Southwest Dermatology Specialists. LTD

  • Dermatology Physician
  • Richfield, MN
  • NPI 1205960317
  NPD
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  NPD (past)
• Skin Specialists, LTD.

  • Dermatology Physician
  • Minneapolis, MN
  • NPI 1013921600
  NPD (past)

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1194248013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 2575",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4924",
            "fax_number": "320-229-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 2575",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4924",
            "fax_number": "320-229-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDNINGEN",
        "first_name": "KYLE",
        "middle_name": "ERICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-23",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "71434-20",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "7125-851",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "70700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krudningen586768@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "krudningen586768@direct.centracare.com",
            "address_1": "1900 Centracare Cir Ste 2575",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563035000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krudningen586768@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "krudningen586768@direct.centracare.com",
            "address_1": "1900 Centracare Cir Ste 2575",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563035000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Timothy N Rowen, PA-C
• Royalty Care
• Penny L Rubesh, FNP
• Kellee Rucks, APRN, FNP-BC
• Mark Allen Rudel, PA
• Patrick Lee Rudolph
• Eric Rudrud, PH.D.
• Shawn Joseph Rue
• Daniel Rueckert
• Sarah Rueter

• Dermatology Physician in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.