Individual provider Active NPI

Kunal Manohar Patel

  • Neuroradiology Physician
  • St Louis Park, MN
National Provider Identifier
1578768131
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
79257 Issued in MN
Practice address
5775 Wayzata Blvd Ste 190
St Louis Park, MN 55416-2627
Phone
(952) 541-1840
Fax
(952) 543-6524
NPI assigned
Jun 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 60302-20 WI
Student in an Organized Health Care Education/Training Program 390200000X 4301090426 MI
Student in an Organized Health Care Education/Training Program 390200000X MN
Neuroradiology Physician 2085N0700X 79257 MN Primary

Addresses

Primary practice location

5775 Wayzata Blvd Ste 190
St Louis Park, MN 55416-2627

Mailing address

5775 Wayzata Blvd Ste 400
St Louis Park, MN 55416-1271
Phone (952) 541-1840

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
I20250721003346 MN Practitioner - Diagnostic RadiologyPractitioner - Other (Physician) 9032351390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Wisconsin School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Scanning Consultants PAGroup PAC ID 9032005376, 82 clinicians

Practice addresses (Care Compare)

5775 Wayzata Blvd
Suite 190
St Louis Park, MN 55416-2627
Phone (952) 541-1840

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79257MNMDNeuroradiology Physician
60302-20WIMDDiagnostic Radiology Physician
4301090426MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince Aug 29, 2025 Accepting new patients
Thedacare Regional Medical Center-Neenah, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince Aug 29, 2025 Accepting new patients
Cdi Twin Cities ASC LLC Current Accepting new patients

Locations

5775 Wayzata Blvd
Ste 400
St Louis Park, MN 55416
Phone (952) 525-6338

5775 Wayzata Blvd
Ste 190
St Louis Park, MN 55416
Phone (952) 525-6338

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1578768131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 400",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161271",
            "telephone_number": "952-541-1840",
            "fax_number": "952-543-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 190",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162627",
            "telephone_number": "952-541-1840",
            "fax_number": "952-543-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KUNAL",
        "middle_name": "MANOHAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "60302-20",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301090426",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MN",
            "license": "79257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.