Individual provider Active NPI

Eric A Khetia, MD

  • Orthopaedic Surgery Physician
  • Eagan, MN
National Provider Identifier
1427038371
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
49168 Issued in MN
Practice address
1185 Town Centre Dr Ste 100
Eagan, MN 55123-1188
Phone
(651) 968-5230
Fax
(651) 994-3982
NPI assigned
Jan 18, 2006
Last updated
Jul 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 49168 MN Primary

Addresses

Primary practice location

1185 Town Centre Dr Ste 100
Eagan, MN 55123-1188

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4919
Phone (651) 968-5042

Other identifiers 1

IdentifierTypeStateIssuer
P00340061OtherMNRAILROAD MEDICARE

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
I20060905000349 MN Practitioner - Orthopedic Surgery 2567491897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Missouri, Kansas City, School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

2620 Eagan Woods Dr
Eagan, MN 55121-1138
Phone (651) 968-5201

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Orthopedics, LTD Orthopaedic Surgery CurrentSince Aug 31, 2006 Accepting new patients
Summit Orthopedics LTD Orthopaedic Surgery CurrentSince Aug 31, 2006 Accepting new patients
Summit Orthopedics LTD Current Accepting new patients
Ilbnc, P.a. Past Accepting new patients
Orthopaedic Clinical Assoc Inc. Past Accepting new patients

Locations

1185 Town Centre Dr
Ste 100
Eagan, MN 55123
Phone (651) 968-5230

2620 Eagan Woods Dr
Ste 100
Eagan, MN 55121
Phone (651) 968-5230

17210 Kenyon Ave
Lakeville, MN 55044
Phone (651) 968-5960

1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5335

2620 Eagan Woods Dr
Saint Paul, MN 55121
Phone (651) 271-1592

3580 Arcade St
Vadnais Heights, MN 55127
Phone (651) 968-5770

2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5600

710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042

Interoperability endpoints

  • Direct secure messaging: ericakhetia@sol.allscriptsdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1427038371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254919",
            "telephone_number": "651-968-5042",
            "fax_number": "651-968-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 TOWN CENTRE DR STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231188",
            "telephone_number": "651-968-5230",
            "fax_number": "651-994-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHETIA",
        "first_name": "ERIC",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "49168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00340061",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.