NPIMap

Individual provider Active NPI

Kyle Shaune Nelson, MD

  • Neurological Surgery Physician
  • Coon Rapids, MN
National Provider Identifier
1194987289
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
57276 Issued in MN
Practice address
11850 Blackfoot St NW
Suite 490
Coon Rapids, MN 55433-2578
Phone
(763) 427-1137
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 5933 NE
Neurological Surgery Physician 207T00000X 57276 MN Primary

Addresses

Primary practice location

11850 Blackfoot St NW
Suite 490
Coon Rapids, MN 55433-2578

Mailing address

11850 Blackfoot St NW
Suite 490
Coon Rapids, MN 55433-2578
Phone (763) 427-1137

Other practice location 1

913 E 26th St Ste 305
Minneapolis, MN 55404-4515
Phone (612) 871-7278

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knelson265709@excellian.direct.allina.com Direct

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
I20140612002248 MN Practitioner - Neurosurgery 6406070481 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Minnesota Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (651) 262-7633

913 E 26TH St
Minneapolis, MN 55404-4515
Phone (612) 871-7278

Hospital & facility affiliations

  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038
  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Merit-based Incentive Payment System (MIPS)

Final score
69.1 of 100Reported as group
Quality
39.3
Improvement activities
40
Cost
68.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57276MNMDNeurological Surgery Physician
5933NEMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Minnesota Neurosurgical Trauma Associates, PLLC Neurological Surgery CurrentSince Jul 1, 2014 Accepting new patients
Metropolitan Neurosurgery, PA Neurological Surgery CurrentSince Jul 1, 2014 Accepting new patients
Allina Health System CurrentSince Nov 15, 2024 Accepting new patients
Allina Health System CurrentSince Nov 15, 2024 Accepting new patients
Allina Health System CurrentSince Nov 15, 2024 Accepting new patients
Allina Health System Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

11850 Blackfoot St NW
Ste 490
Minneapolis, MN 55433
Phone (612) 871-7278

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

913 E 26th St
Ste 305
Minneapolis, MN 55404
Phone (612) 871-7278

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11793/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kyle.nelson.1@11793.direct.athenahealth.com

Organizations & group practices 8

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 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1194987289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW",
            "address_2": "SUITE 490",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332578",
            "telephone_number": "763-427-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW",
            "address_2": "SUITE 490",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332578",
            "telephone_number": "763-427-1137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "913 E 26th St Ste 305",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044515",
            "country_code": "US",
            "telephone_number": "612-871-7278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KYLE",
        "middle_name": "SHAUNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NE",
            "license": "5933",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MN",
            "license": "57276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knelson265709@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "913 E 26th St Ste 305",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554044515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.