Individual provider Active NPI

Xiaoming Dong, M.D.

  • Neurology Physician
  • Golden Valley, MN
National Provider Identifier
1265488340
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
47188 Issued in MN
Practice address
4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone
(763) 588-0661
Fax
(763) 302-4345
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 47188 MN
Neurology Physician 2084N0400X 47188 MN Primary

Addresses

Primary practice location

4225 Golden Valley Rd
Golden Valley, MN 55422-4215

Mailing address

4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone (763) 588-0661

Other practice location 1

9645 Grove Cir N Ste 100
Maple Grove, MN 55369-2682
Phone (763) 302-4114

Other identifiers 8

IdentifierTypeStateIssuer
P00229204OtherMNRAILROAD MEDICARE
1265488340MedicaidMN
1042763OtherMNPREFERRED ONE
340G7DOOtherMNBCBS OF MN
HP48191OtherMNHEALTHPARTNERS
0500676OtherMNMEDICA
132773C029OtherMNUCARE
34602200MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address xdong1173@direct.northmemorial.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20041207000682 MN Practitioner - NeurologyPractitioner - Nephrology 9739145160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minneapolis Clinic of Neurology LTDGroup PAC ID 5496668659, 75 clinicians

Practice addresses (Care Compare)

4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone (763) 588-0661

Hospital & facility affiliations

  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001
  • Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214

Merit-based Incentive Payment System (MIPS)

Final score
92.7 of 100Reported as individual
Quality
84.24
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minneapolis Clinic of Neurology, LTD Neurology CurrentSince Aug 1, 2005 Accepting new patients

Locations

9645 Grove Cir N
Ste 100
Maple Grove, MN 55369
Phone (763) 302-4114

4225 Golden Valley Rd
Minneapolis, MN 55422
Phone (612) 588-0661

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

433 Elm St N
Sauk Centre, MN 56378
Phone (320) 352-6591

Interoperability endpoints

  • Direct secure messaging: xdong22847@direct.centracare.com

Organizations & group practices 1

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1265488340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224215",
            "telephone_number": "763-588-0661",
            "fax_number": "763-287-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224215",
            "telephone_number": "763-588-0661",
            "fax_number": "763-302-4345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9645 Grove Cir N Ste 100",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553692682",
            "country_code": "US",
            "telephone_number": "763-302-4114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONG",
        "first_name": "XIAOMING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "MN",
            "license": "47188",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "47188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00229204",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265488340",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1042763",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "340G7DO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP48191",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0500676",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "132773C029",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34602200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "xdong1173@direct.northmemorial.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4225 Golden Valley Rd",
            "city": "Golden Valley",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554224215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.