Individual provider Active NPI

Peter Conklin, M.D.

  • Diagnostic Radiology Physician
  • Saint Paul, MN
National Provider Identifier
1447200605
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
31824 Issued in MN
Practice address
250 Thompson St
Saint Paul, MN 55102-2370
Phone
(651) 292-2000
Fax
(651) 292-2136
NPI assigned
May 10, 2006
Last updated
Apr 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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 31824 MN Primary

Addresses

Primary practice location

250 Thompson St
Saint Paul, MN 55102-2370

Mailing address

4801 W 81St St
Suite 108
Bloomington, MN 55437-1111
Phone (952) 837-9700

Other practice location 1

4801 W 81st St
Suite 108
Bloomington, MN 55437-1111
Phone (952) 837-9700

Other practice location 2

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone (763) 780-9155

Other identifiers 1

IdentifierTypeStateIssuer
673307700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.04 of 100Reported as apm
Quality
89.99
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Mar 1, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Allina Health System Current Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
Fairview Health Services CurrentSince Jul 15, 2019 Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
Allina Health System CurrentSince Mar 1, 2019 Accepting new patients
Consulting Radiologists, LTD Diagnostic Radiology PastSince Mar 1, 2019 Accepting new patients

Locations

6545 France Ave S
Ste 471
Edina, MN 55435
Phone (952) 836-3558

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

550 Osborne Rd NE
Minneapolis, MN 55432
Phone (763) 236-3800

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

Organizations & group practices 10

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1447200605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 W 81ST ST",
            "address_2": "SUITE 108",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371111",
            "telephone_number": "952-837-9700",
            "fax_number": "952-837-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 THOMPSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022370",
            "telephone_number": "651-292-2000",
            "fax_number": "651-292-2136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 W 81st St",
            "address_2": "Suite 108",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554371111",
            "country_code": "US",
            "telephone_number": "952-837-9700",
            "fax_number": "952-837-9701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9055 Springbrook Dr NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554335841",
            "country_code": "US",
            "telephone_number": "763-780-9155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "31824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "673307700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.