Individual provider Active NPI

Timothy Colin O'Keefe

  • Clinical Social Worker
  • Edina, MN
National Provider Identifier
1689253304
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27582 Issued in MN
Practice address
3400 W 66TH St Ste 400
Edina, MN 55435-2134
Phone
(612) 672-6999
NPI assigned
Apr 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 27582 MN Primary

Addresses

Primary practice location

3400 W 66TH St Ste 400
Edina, MN 55435-2134

Mailing address

2450 Riverside Ave # F140
Minneapolis, MN 55454-1450
Phone (612) 672-6999

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210601000144 MN Practitioner - Clinical Social Worker 8729487418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

3305 Central Park Village Dr
Eagan, MN 55121-7707

600 W 98TH St
Bloomington, MN 55420-4773
Phone (952) 885-6150

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27582MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Apr 6, 2021 Accepting new patients
Fairview Express Care CurrentSince Apr 6, 2021 Accepting new patients
Fairview Express Care Current Accepting new patients

Locations

600 W 98th St
Minneapolis, MN 55420
Phone (952) 881-2651

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

2450 Riverside Ave
#F140
Minneapolis, MN 55454

3400 W 66th St
Ste 400
Minneapolis, MN 55435
Phone (952) 836-3637

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.

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1689253304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE # F140",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-672-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST STE 400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352134",
            "telephone_number": "612-672-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KEEFE",
        "first_name": "TIMOTHY",
        "middle_name": "COLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.