NPIMap

Individual provider Active NPI

Kevin Rene Grullon, M.D.

  • Pulmonary Disease Physician
  • Minneapolis, MN
National Provider Identifier
1295976645
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
57753 Issued in MN
Practice address
800 E 28TH St Ste H2100
Minneapolis, MN 55407-3723
Phone
(612) 863-3900
NPI assigned
Mar 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 4301082239 MI
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 4301082239 MI
Sleep Medicine (Internal Medicine) Physician 207RS0012X 4301082239 MI
Pulmonary Disease Physician 207RP1001X 57753 MN Primary

Addresses

Primary practice location

800 E 28TH St Ste H2100
Minneapolis, MN 55407-3723

Mailing address

PO Box 43
Minneapolis, MN 55440-0043
Phone (612) 262-1166

Other practice location 1

3535 W 13 Mile Rd Ste 507
Royal Oak, MI 48073-6770
Phone (248) 551-0497

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgrullon265158@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
I20140709001893 MN Practitioner - Pulmonary DiseasePractitioner - Sleep Medicine 2163690967 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Sleep Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

7450 France Ave S
Suite 210
Edina, MN 55435-4784
Phone (612) 262-7100

800 E 28TH St
Suite H2100
Minneapolis, MN 55407-3723
Phone (612) 863-3900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.4 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
78.01

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301082239MIMDCritical Care Medicine (Internal Medicine) Physician
57753MNMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jun 1, 2016 Accepting new patients
Allina Health System CurrentSince Jul 1, 2024 Accepting new patients
Minnesota Lung Center LTD Pulmonary Disease CurrentSince Jul 1, 2014 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jun 1, 2016 Accepting new patients
Northstar Sleep Center LLC CurrentSince Jul 1, 2014 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

3800 Coon Rapids Blvd NW
Ste 3800
Coon Rapids, MN 55433
Phone (612) 262-7100

7450 France Ave S
Ste 210
Edina, MN 55435
Phone (763) 420-1010

800 E 28th St
Ste H2100
Minneapolis, MN 55407
Phone (612) 863-3900

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

3800 Coon Rapids Blvd NW
#380024
Minneapolis, MN 55433

3800 Coon Rapids Blvd NW
#380
Minneapolis, MN 55433

3800 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 452-3955

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

920 E 28th St
Ste 700
Minneapolis, MN 55407
Phone (612) 863-9062

4570 77th St W
Ste 150
Minneapolis, MN 55435

8200 42nd Ave N
New Hope, MN 55427
Phone (763) 531-7460

2855 Campus Dr
Ste 550
Plymouth, MN 55441
Phone (763) 520-4949

Interoperability endpoints

  • Direct secure messaging: kevin.grullon.nss@direct.mlcmsi.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kgrullon265158@excellian.direct.allina.com
  • Direct secure messaging: kevin.grullon@direct.mlcmsi.nextgenshare.com

Organizations & group practices 9

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1295976645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST STE H2100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 W 13 Mile Rd Ste 507",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736770",
            "country_code": "US",
            "telephone_number": "248-551-0497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRULLON",
        "first_name": "KEVIN",
        "middle_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-16",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301082239",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301082239",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MI",
            "license": "4301082239",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "57753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgrullon265158@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "800 E 28th St Ste H2100",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554073723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.