NPIMap

Individual provider Active NPI

Mitchell Harris Crider, MD

  • Diagnostic Radiology Physician
  • Plymouth, MN
National Provider Identifier
1306980875
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
49502 Issued in MN
Practice address
2800 Campus Dr Ste 10
Plymouth, MN 55441-8812
Phone
(763) 559-2171
NPI assigned
Feb 17, 2007
Last updated
Feb 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 49502 MN Primary

Addresses

Primary practice location

2800 Campus Dr Ste 10
Plymouth, MN 55441-8812

Mailing address

2800 Campus Dr Ste 10
Plymouth, MN 55441-8812
Phone (763) 559-2171

Other identifiers 1

IdentifierTypeStateIssuer
P00864018OtherMNRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090624000153 MN Practitioner - Diagnostic Radiology 6103977640 Reassigns benefits to 3 organizations
I20230315003086 WI Practitioner - Diagnostic Radiology 6103977640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Creighton University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Imaging Partners LLCGroup PAC ID 1557734225, 29 clinicians
Minneapolis Radiology Associates LTDGroup PAC ID 5698661007, 44 clinicians
West Imaging LLCGroup PAC ID 7315833720, 29 clinicians
Minnesota Diagnostic Imaging Partners LLCGroup PAC ID 5890681209, 32 clinicians

Practice addresses (Care Compare)

2651 Hillcrest Dr
Suite 103
Hudson, WI 54016-9919
Phone (763) 559-2171

2800 Campus Dr
Suite 10
Plymouth, MN 55441-2669
Phone (763) 559-2171

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49502MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Imaging, LLC Diagnostic Radiology CurrentSince Jan 13, 2023 Accepting new patients
Hudson Imaging Partners LLC Diagnostic Radiology CurrentSince Jan 3, 2023 Accepting new patients
Minneapolis Radiology Associates, LTD. Diagnostic Radiology CurrentSince Jan 13, 2023 Accepting new patients
Minnesota Diagnostic Imaging Partners, LLC Diagnostic Radiology CurrentSince Jan 13, 2023 Accepting new patients
Mayo Clinic Past Accepting new patients
Consulting Radiologists, LTD Diagnostic Radiology Past Accepting new patients

Locations

9855 Hospital Dr
Ste 150
Maple Grove, MN 55369
Phone (763) 398-6341

2800 Campus Dr
Ste 10
Plymouth, MN 55441
Phone (763) 398-4400

2800 Campus Dr
Ste 20
Plymouth, MN 55441
Phone (763) 398-8700

2800 Campus Dr
Ste 30
Plymouth, MN 55441
Phone (763) 398-2203

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

2651 Hillcrest Dr
Ste 103
Hudson, WI 54016
Phone (763) 559-2171

Interoperability endpoints

  • Direct secure messaging: mcrider654230@direct.centracare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1306980875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 CAMPUS DR STE 10",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554418812",
            "telephone_number": "763-559-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CAMPUS DR STE 10",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554418812",
            "telephone_number": "763-559-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIDER",
        "first_name": "MITCHELL",
        "middle_name": "HARRIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-17",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "49502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00864018",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.