NPIMap

Individual provider Active NPI

Keith Mitchell Skubitz, MD

  • Medical Oncology Physician
  • Minneapolis, MN
National Provider Identifier
1215019203
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
23896 Issued in MN
Practice address
424 Harvard Street SE
Masonic Cancer Center, First Floor, Suite M100
Minneapolis, MN 55455
Phone
(612) 625-5411
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23896 MN
Medical Oncology Physician 207RX0202X 23896 MN Primary

Addresses

Primary practice location

424 Harvard Street SE
Masonic Cancer Center, First Floor, Suite M100
Minneapolis, MN 55455

Mailing address

420 Delaware Street SE
University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 625-5411

Other identifiers 11

IdentifierTypeStateIssuer
10387MedicaidND
36-00013OtherMNMEDICA PRIMARY
597099OtherMNARAZ
30713600MedicaidWI
2T180SKOtherMNBLUE CROSS BLUE SHIELD
7777470MedicaidSD
100796OtherMNUCARE
757873300MedicaidMN
36-00276OtherMNMEDICA CHOICE
1009310OtherMNPREFERRED ONE
HP22239OtherMNHEALTH PARTNERS

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
I20071207000242 MN Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 2062501570 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology/Oncology
Education
Johns Hopkins University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians

Practice addresses (Care Compare)

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 273-8383

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Fairview Lakes Health Services Hospital, Wyoming, MN, CCN 240050
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078
  • Essentia Health St Joseph'S Medical Center Hospital, Brainerd, MN, CCN 240075
  • Fairview Northland Regional Hospital Hospital, Princeton, MN, CCN 240141

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Mar 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Mar 1, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Health Services CurrentSince May 1, 2010 Accepting new patients
Fairview Express Care CurrentSince May 1, 2010 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

420 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-6483

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

909 Fulton St SE
Ste 202
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

10961 Club West Pkwy
Minneapolis, MN 55449
Phone (763) 572-5700

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

424 Harvard St SE
Fl First
Minneapolis, MN 55455
Phone (612) 625-5411

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • Direct secure messaging: kskubitz148102@fairview.direct-ci.com

Organizations & group practices 12

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1215019203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE STREET SE",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-625-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 HARVARD STREET SE",
            "address_2": "MASONIC CANCER CENTER, FIRST FLOOR, SUITE M100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-625-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKUBITZ",
        "first_name": "KEITH",
        "middle_name": "MITCHELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "23896",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MN",
            "license": "23896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10387",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PRIMARY",
            "identifier": "36-00013",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "597099",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30713600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2T180SK",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7777470",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "100796",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "757873300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "36-00276",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1009310",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP22239",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.