Patrick Van Kirk, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

LP05002 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 606-4286

Fax

(401) 444-5090

NPI assigned

Apr 25, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Anesthesiology

Education

Georgetown University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southdale Anesthesiologists LLCGroup PAC ID 6709842461, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southdale Anesthesiologists, LLC

  • Anesthesiology Physician
  • Edina, MN
  • NPI 1154381804

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1699752915
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1932260833
  Care Compare affiliation

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1508420571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-606-4286",
            "fax_number": "401-444-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-606-4286",
            "fax_number": "401-444-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN KIRK",
        "first_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-25",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "RI",
            "license": "LP05002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeleine Clare Van Dussen, RDN
• Jennifer Rose Van Hook, PHARMD
• Susan K. Van Horne, RN
• Kelsey Van Housen, PA-C
• Emily Van Kirk, MD
• Jill Van Leesten, LCSW
• Tara E. Van Tassel, M.A., LMHC
• Justin Vana, PSY.D.
• Ari Vandersluis, DO
• Anneka Wynne Vanderveen, LICSW

• Anesthesiology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Anesthesiology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.