Individual provider Active NPI

Kara Elizabeth Fay Pettigrew, MD

  • Family Medicine Physician
  • Fridley, MN
National Provider Identifier
1548244791
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
42716 Issued in MN
Practice address
7675 Madison St NE
Fridley, MN 55432-2753
Phone
(763) 785-4500
Fax
(763) 785-3314
NPI assigned
Dec 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 42716 MN Primary

Addresses

Primary practice location

7675 Madison St NE
Fridley, MN 55432-2753

Mailing address

7675 Madison St NE
Fridley, MN 55432-2753
Phone (763) 785-4500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100310000582 MN Practitioner - Family Practice 3577646934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

1000 W 140TH St
Suite 100
Burnsville, MN 55337-4835
Phone (952) 435-0303

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42716MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Nov 1, 2020 Accepting new patients
Infinite Health Collaborative, PA Family Medicine CurrentSince Nov 1, 2020 Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

1000 W 140th St
Ste 100
Burnsville, MN 55337
Phone (952) 435-0303

1000 W 140th St
#202
Burnsville, MN 55337
Phone (952) 892-2200

9855 Hospital Dr
Ste 102A
Maple Grove, MN 55369
Phone (763) 581-9220

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

11855 Ulysses St NE
Minneapolis, MN 55434
Phone (763) 420-1010

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

Interoperability endpoints

  • Direct secure messaging: kpettigrew600303@fairview.direct-ci.com

Organizations & group practices 3

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 6

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548244791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7675 MADISON ST NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322753",
            "telephone_number": "763-785-4500",
            "fax_number": "763-785-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7675 MADISON ST NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322753",
            "telephone_number": "763-785-4500",
            "fax_number": "763-785-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "KARA",
        "middle_name": "ELIZABETH FAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "42716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.