NPIMap

Individual provider Active NPI

Kevin J Mullaney, MD

  • Orthopaedic Surgery of the Spine Physician
  • Bloomington, MN
National Provider Identifier
1447289160
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
45583 Issued in MN
Practice address
8100 Northland Dr
Bloomington, MN 55431-4800
Phone
(952) 831-8742
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 45583 MN
Orthopaedic Surgery Physician 207X00000X 45583 MN
Orthopaedic Surgery of the Spine Physician 207XS0117X 45583 MN Primary

Addresses

Primary practice location

8100 Northland Dr
Bloomington, MN 55431-4800

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

913 E 26th St
600
Minneapolis, MN 55404-4515
Phone (612) 775-6200

Other identifiers 1

IdentifierTypeStateIssuer
747647700MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmullaney87049@excellian.direct.allina.com

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
I20031217000701 MN Practitioner - Orthopedic Surgery 6406753474 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Albany Medical College of Union University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

6500 Excelsior Blvd
St Louis Park, MN 55426-4702

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion234
Laminectomy or laminotomy (partial removal of spine bones)110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45583MNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Sep 27, 2024 Accepting new patients
Park Nicollet Clinic Family Medicine Current Accepting new patients
Tria Orthopaedic Center LLC Orthopaedic Surgery CurrentSince Jan 1, 2011 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Aug 1, 2003 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Sep 27, 2024 Accepting new patients
St Francis Regional Medical Center Past Accepting new patients
Capital Region Orthopaedic Associates, PC Orthopaedic Surgery Past Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

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

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

913 E 26th St
Ste 600
Minneapolis, MN 55404
Phone (612) 775-6257

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

1700 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 993-7800

Interoperability endpoints

  • Direct secure messaging: kmullaney87049@excellian.direct.allina.com
  • Direct secure messaging: kmullaney157236@direct.healthpartners.com
  • Direct secure messaging: kevin.mullaney.p2@direct.tcspine.nextgenshare.com

Organizations & group practices 8

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1447289160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 NORTHLAND DR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314800",
            "telephone_number": "952-831-8742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "913 E 26th St",
            "address_2": "600",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044515",
            "country_code": "US",
            "telephone_number": "612-775-6200",
            "fax_number": "612-775-6222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLANEY",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "45583",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "45583",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MN",
            "license": "45583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "747647700",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmullaney87049@excellian.direct.allina.com",
            "affiliation": "N",
            "address_1": "913 E 26th St",
            "address_2": "600",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554044515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.