Paul M Kietzmann, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

49324 Issued in MN

Practice address

610 30TH Ave W
Alexandria, MN 56308-3426

Phone

(320) 763-5123

Fax

(320) 763-5749

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of Minnesota Medical School, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alomere HealthGroup PAC ID 9931690047, 123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vivie Home Health Home health agency, Alexandria, MN, CCN 248096
• Vivie Hospice Hospice, Alexandria, MN, CCN 241592
• Alomere Health Hospital, Alexandria, MN, CCN 240030
• St Williams Living Center Nursing home, Parkers Prairie, MN, CCN 245588

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkietzmann28193@direct.centracare.com

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.

• Alomere Health

  • General Acute Care Hospital
  • Alexandria, MN
  • NPI 1558236091
  Medicare reassignment Care Compare group NPD
• Alexandria Clinic PA

  • Multi-Specialty Clinic/Center
  • Alexandria, MN
  • NPI 1346211315
  NPD
• Alomere Health

  • Durable Medical Equipment & Medical Supplies
  • Willmar, MN
  • NPI 1467318246
  NPD
• Douglas County Hospital

  • General Acute Care Hospital
  • Alexandria, MN
  • NPI 1164424305
  NPD
• West Central Pathology and Laboratory Medicine PA

  • Clinical Medical Laboratory
  • Alexandria, MN
  • NPI 1811988025
  NPD
• Douglas County Hospital

  • Orthopaedic Surgery Physician
  • Alexandria, MN
  • NPI 1427342138
  NPD (past)

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

• Alomere Health

  • General Acute Care Hospital
  • Alexandria, MN
  • NPI 1558236091
  Care Compare affiliation
• Knute Nelson

  • Home Health Agency
  • Alexandria, MN
  • NPI 1477676229
  Care Compare affiliation
• Knute Nelson

  • Community Based Hospice Care Agency
  • Alexandria, MN
  • NPI 1548517675
  Care Compare affiliation
• St. William'S Living Center

  • Skilled Nursing Facility
  • Parkers Prairie, MN
  • NPI 1538292156

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1497880561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 30TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083426",
            "telephone_number": "320-763-5123",
            "fax_number": "320-763-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 30TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083426",
            "telephone_number": "320-763-5123",
            "fax_number": "320-763-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIETZMANN",
        "first_name": "PAUL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "49324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "49324",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA9121053818",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "925198000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "01-30293 149780561",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI-CARE",
            "identifier": "A086",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497880561",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP86106",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrice L Keipe, HYGIENIST
• Ashley Kellen
• Terence James Kennedy, MD
• Nicole Lynn Ketelsen, PHARMD
• Christine Marie Kieffer, APRN, FNP-C
• Katy Rose Kiger, BA
• Nancy Claire Kiger, PHD, LP
• Kinetic Wellness, LLC
• Nathan Jeffrey King, APRN, CRNA
• Jessica Lynn Kirckof

• Family Medicine Physician in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.