Individual provider Active NPI

Nathaniel S Kreykes, M.D.

  • Pediatrics Physician
  • Minneapolis, MN
National Provider Identifier
1609818061
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
45565 Issued in MN
Practice address
2530 Chicago Ave
Suite 550
Minneapolis, MN 55404-4289
Phone
(612) 813-8000
Fax
(612) 813-8005
NPI assigned
Jun 11, 2006
Last updated
Aug 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 45565 MN Primary
Pediatric Surgery Physician 2086S0120X 45565 MN

Addresses

Primary practice location

2530 Chicago Ave
Suite 550
Minneapolis, MN 55404-4289

Mailing address

2530 Chicago Ave
Suite 550
Minneapolis, MN 55404-4289
Phone (612) 813-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040211000735 MN Practitioner - Pediatric MedicinePractitioner - General Surgery 1254225139 Reassigns benefits to 2 organizations
I20221207002964 ND Practitioner - Pediatric MedicinePractitioner - General Surgery 1254225139

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45565MNMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Surgical Associates LTD Pediatric Surgery CurrentSince Jun 1, 2012 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Apr 1, 2014 Accepting new patients
Childrens Health Care Past Accepting new patients

Locations

2530 Chicago Ave
Ste 550
Minneapolis, MN 55404
Phone (612) 813-8006

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

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

4530 77th St W
Ste 205
Minneapolis, MN 55435
Phone (952) 835-3375

347 Smith Ave N
Ste 502
Saint Paul, MN 55102
Phone (651) 248-2113

5354 Edgewood Dr
Saint Paul, MN 55112

Interoperability endpoints

  • Direct secure messaging: nathaniel.kreykes@psal.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1609818061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 550",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044289",
            "telephone_number": "612-813-8000",
            "fax_number": "612-813-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 550",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044289",
            "telephone_number": "612-813-8000",
            "fax_number": "612-813-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREYKES",
        "first_name": "NATHANIEL",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "45565",
            "primary": true
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "MN",
            "license": "45565",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.