NPIMap

Individual provider Active NPI

Maxwell David Leither

  • Nephrology Physician
  • Brooklyn Center, MN
National Provider Identifier
1538459755
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
57808 Issued in MN
Practice address
6200 Shingle Creek Pkwy Ste 250
Brooklyn Center, MN 55430-2107
Phone
(763) 561-5349
NPI assigned
Apr 8, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 57808 MN Primary

Addresses

Primary practice location

6200 Shingle Creek Pkwy Ste 250
Brooklyn Center, MN 55430-2107

Mailing address

6200 Shingle Creek Pkwy Ste 250
Brooklyn Center, MN 55430-2107
Phone (763) 561-5349

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mleither351523@excellian.direct.allina.com Direct

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
I20150513002445 MN Practitioner - NephrologyPractitioner - Internal Medicine 6002136165 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kidney Specialists of Minnesota, PAGroup PAC ID 5092616029, 33 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2085 Rice St
Roseville, MN 55113-6807
Phone (651) 489-9035

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jan 10, 2023 Accepting new patients
Allina Health System Current Accepting new patients
North Memorial Health Care CurrentSince Nov 1, 2017 Accepting new patients
Kidney Specialists of Minnesota, PA Nephrology CurrentSince Jul 1, 2017 Accepting new patients
Regency Hospital of Minneapolis, LLC CurrentSince Jul 4, 2018 Accepting new patients
North Memorial Health Care CurrentSince Nov 1, 2017 Accepting new patients
North Memorial Health Care Current Accepting new patients
Sarah L. Hart, PH.D., LLC PastSince Jul 24, 2022 Accepting new patients
Kate M Hathaway, PHD, LP, Inc PastSince May 1, 2014 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

1300 Hidden Lakes Pkwy
Minneapolis, MN 55422
Phone (763) 588-2750

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

6200 Shingle Creek Pkwy
Ste 250
Minneapolis, MN 55430
Phone (612) 823-8001

6200 Shingle Creek Pkwy
Ste 260
Minneapolis, MN 55430
Phone (763) 544-0696

6601 Lyndale Ave S
Ste 220
Richfield, MN 55423
Phone (612) 823-8001

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

2085 Rice St
Saint Paul, MN 55113
Phone (651) 489-9035

Interoperability endpoints

  • Direct secure messaging: mleither16484@direct.acumenmd.com

Organizations & group practices 10

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1538459755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 SHINGLE CREEK PKWY STE 250",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302107",
            "telephone_number": "763-561-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 SHINGLE CREEK PKWY STE 250",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302107",
            "telephone_number": "763-561-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITHER",
        "first_name": "MAXWELL",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-08",
        "last_updated": "2022-07-21",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MN",
            "license": "57808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mleither351523@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "6200 Shingle Creek Pkwy Ste 250",
            "city": "Brooklyn Center",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554302107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

Verify at the official NPI Registry.