Kristine L Eskuchen, M.D.
Individual provider Active NPI Family Medicine Physician · Rogers, MN
NPI 1194716639 · NPPES record last updated Feb 17, 2011
Key facts
- NPI
- 1194716639
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 37971 (MN)
- Practice address
- 21395 John Milless Dr
Rogers, MN 55374-4402 - Phone
- (763) 504-6400
- NPI assigned
- Nov 3, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031205000477 | MN | Practitioner - Family Practice | 3577468156 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37971 | MN | MD | Family Medicine Physician |
Interoperability endpoints
- kristineeskuchen@northwestf.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 37971 | MN | Yes |
Addresses
Primary practice location
21395 John Milless Dr
Rogers, MN 55374-4402
Mailing address
5502 W Broadway Ave
Crystal, MN 55428-3508
Phone (763) 504-6500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 713819900 | Medicaid | MN |
Other providers in Rogers, MN
- Bonnie Kay Ellingboe
- Noelle Ellis
- Elselia Home Healthcare Services Inc
- Madeline Emlaw
- Danielle Erler
- David Allen Everson
- Sophia Faber
- Donald Joe Fahey-Ahrndt
- Fairview Clinics
- Megan Joelle Fallert
All providers in Rogers, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.