NPIMap

Individual provider Active NPI

Balaji Krishnan, MD

  • Clinical Cardiac Electrophysiology Physician
  • St Louis Park, MN
National Provider Identifier
1477784288
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
53606 Issued in MN
Practice address
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone
(952) 993-3010
NPI assigned
Jul 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 53606 MN
Clinical Cardiac Electrophysiology Physician 207RC0001X 53606 MN Primary

Addresses

Primary practice location

6500 Excelsior Blvd
St Louis Park, MN 55426-4702

Mailing address

825 Berry St
Apt #405
Saint Paul, MN 55114-1471
Phone (612) 227-9201

Other practice location 1

825 Berry St
Apt #405
Saint Paul, MN 55114-1471
Phone (612) 227-9201

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
I20130308000170 MN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac Electrophysiology 6204081615 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology
Education
University of Minnesota Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053
  • Olivia Hospital & Clinic Hospital, Olivia, MN, CCN 241306
  • Hutchinson Health Hospital, Hutchinson, MN, CCN 240187

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair46
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53606MNMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Aug 28, 2017 Accepting new patients
Fairview Express Care CurrentSince Mar 16, 2013 Accepting new patients
Fairview Health Services Current Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Fairview Health Services CurrentSince Mar 16, 2013 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Nov 1, 2020 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Nov 1, 2020 Accepting new patients
Park Nicollet Clinic CurrentSince Aug 28, 2017 Accepting new patients

Locations

9555 Upland Ln N
Maple Grove, MN 55369
Phone (952) 993-1440

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

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

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

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

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

Organizations & group practices 9

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 8

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": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1477784288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 BERRY ST",
            "address_2": "APT #405",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141471",
            "telephone_number": "612-227-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264702",
            "telephone_number": "952-993-3010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Berry St",
            "address_2": "Apt #405",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551141471",
            "country_code": "US",
            "telephone_number": "612-227-9201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISHNAN",
        "first_name": "BALAJI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-29",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "53606",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MN",
            "license": "53606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.