NPIMap

Individual provider Active NPI

Kristin Gendron, M.D.

  • Otolaryngology Physician
  • Woodbury, MN
National Provider Identifier
1457307316
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
49403 Issued in MN
Practice address
217 Radio Dr
Woodbury, MN 55125-5805
Phone
(651) 702-0750
Fax
(651) 645-6166
NPI assigned
May 25, 2006
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 52468-20 WI
Otolaryngology Physician 207Y00000X 49403 MN Primary

Addresses

Primary practice location

217 Radio Dr
Woodbury, MN 55125-5805

Mailing address

215 Radio Dr Ste 202
Woodbury, MN 55125-5822
Phone (651) 702-0570

Other practice location 1

2651 Hillcrest Dr Ste 302
Hudson, WI 54016-9919
Phone (651) 702-0750

Other practice location 2

11020 161st Street West
Lakeville, MN 55044
Phone (651) 702-0750

Other practice location 3

3460 Promenade Ave
Eagan, MN 55123-4404
Phone (651) 702-0750

Other practice location 4

3590 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 702-0750

Other identifiers 1

IdentifierTypeStateIssuer
065435000MedicaidMN

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
I20070822000818 MN Practitioner - Otolaryngology 0143231704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Perelman School of Med at the University of Pennsylvania, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

217 Radio Dr
Woodbury, MN 55125-5805
Phone (651) 702-0750

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49403MNMDOtolaryngology Physician
52468-20WIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Ancillary Services, Inc CurrentSince Aug 1, 2007 Accepting new patients

Locations

3460 Promenade Ave
Eagan, MN 55123

11020 161st St W
Lakeville, MN 55044

3590 Arcade St
Vadnais Heights, MN 55127

2080 Woodwinds Dr
Ste 240
Woodbury, MN 55125

215 Radio Dr
Ste 202
Woodbury, MN 55125
Phone (651) 867-9007

217 Radio Dr
Woodbury, MN 55125

2651 Hillcrest Dr
Ste 302
Hudson, WI 54016
Phone (651) 241-5290

Organizations & group practices 2

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 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1457307316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 RADIO DR STE 202",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255822",
            "telephone_number": "651-702-0570",
            "fax_number": "651-645-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 RADIO DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255805",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2651 Hillcrest Dr Ste 302",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540169919",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11020 161st Street West",
            "address_purpose": "LOCATION",
            "city": "Lakeville",
            "state": "MN",
            "postal_code": "55044",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3460 Promenade Ave",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551234404",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3590 Arcade St",
            "address_purpose": "LOCATION",
            "city": "Vadnais Heights",
            "state": "MN",
            "postal_code": "551277135",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENDRON",
        "first_name": "KRISTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "52468-20",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "49403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065435000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.