Individual provider Active NPI

Angela M Kelle, MD

  • Pediatric Cardiology Physician
  • Minneapolis, MN
National Provider Identifier
1376864355
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
54152 Issued in MN
Practice address
2530 Chicago Ave Ste 500
Minneapolis, MN 55404-4291
Phone
(612) 813-8800
NPI assigned
Jun 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 54152 MN
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Cardiology Physician 2080P0202X MD462318 PA
Pediatric Cardiology Physician 2080P0202X 54152 MN Primary

Addresses

Primary practice location

2530 Chicago Ave Ste 500
Minneapolis, MN 55404-4291

Mailing address

2530 Chicago Ave Ste 500
Minneapolis, MN 55404-4291
Phone (612) 813-8800

Other practice location 1

200 1st St SW
Rochester, MN 55905-0002
Phone (507) 284-2511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110920000354 MN Practitioner - Pediatric Medicine 0941471130 Reassigns benefits to 5 organizations
I20170922001919 PA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 0941471130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Children'S Health CareGroup PAC ID 2668370966, 76 clinicians

Practice addresses (Care Compare)

2525 Chicago Ave S
Minneapolis, MN 55404-4597
Phone (612) 813-6111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54152MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic LTD Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jul 29, 2022 Accepting new patients
Cook County Hospital District CurrentSince Feb 3, 2026 Accepting new patients
Childrens Health Care CurrentSince Dec 1, 2021 Accepting new patients
Childrens Health Care Pediatrics CurrentSince Dec 1, 2021 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
Lakewood Health System CurrentSince May 26, 2023 Accepting new patients
The Milton S Hershey Medical Center Physcian Group CurrentSince Aug 22, 2017 Accepting new patients
Lakewood Health System Current Accepting new patients
Lakewood Health System CurrentSince May 26, 2023 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Aug 22, 2017 Accepting new patients
The Duluth Clinic LTD CurrentSince Jul 29, 2022 Accepting new patients
Cook County Hospital District Past Accepting new patients
Childrens Health Care Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

515 5th Ave W
Grand Marais, MN 55604
Phone (218) 387-3040

2530 Chicago Ave
Ste 500
Minneapolis, MN 55404
Phone (612) 813-8800

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

49725 County 83
Staples, MN 56479
Phone (218) 894-1033

121 N Nyes Rd
Harrisburg, PA 17112
Phone (717) 531-8674

121 N Nyes Rd
Ste D
Harrisburg, PA 17112
Phone (717) 531-8674

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1376864355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE STE 500",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044291",
            "telephone_number": "612-813-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE STE 500",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044291",
            "telephone_number": "612-813-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050002",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLE",
        "first_name": "ANGELA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "54152",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "PA",
            "license": "MD462318",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MN",
            "license": "54152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.