Active NPI
Clifford E Kashtan, MD
- Pediatric Nephrology Physician
- Minneapolis, MN
National Provider Identifier
1699863274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nephrology Physician
- License
- 28733
- Practice address
- 516 Delaware St SE
PWB Fourth Floor, Room 4-100
Minneapolis, MN 55455 - Phone
- (612) 626-6777
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nephrology Physician | 2080P0210X | 28733 | MN | Primary |
Addresses
Primary practice location
516 Delaware St SE
PWB Fourth Floor, Room 4-100
Minneapolis, MN 55455
Mailing address
420 Delaware St SE
University of Minnesota Physicians MMC 491
Minneapolis, MN 55455
Phone (612) 626-6777
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0012699 | Medicaid | MT | |
| 31-24906 | Other | MN | MEDICA-CHOICE |
| 052035 | Other | MN | FAIRVIEW CARE GIVER ID |
| 109962 | Other | MN | PATIENT CHOICE |
| 2105760 | Medicaid | OH | |
| 101069 | Other | MN | U CARE |
| 31-74533 | Other | MN | MEDICA-PRIMARY |
| 370010935 | Other | MN | RAIL ROAD MEDICARE |
| 629885100 | Medicaid | MN | |
| 1009162 | Other | MN | PREFERRED ONE |
| 30852900 | Medicaid | WI | |
| HP13656 | Other | MN | HEALTH PARTNERS |
| 0506212 | Medicaid | IA | |
| 768184 | Other | MN | AMERICA'S PPO |
| 2T289KA | Other | MN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Current | Accepting new patients | |
| University of Minnesota Physicians | Past | Accepting new patients |
Locations
500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1699863274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 DELAWARE ST SE",
"address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS MMC 491",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-626-6777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 DELAWARE ST SE",
"address_2": "PWB FOURTH FLOOR, ROOM 4-100",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-626-6777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASHTAN",
"first_name": "CLIFFORD",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0210X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Nephrology",
"state": "MN",
"license": "28733",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0012699",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA-CHOICE",
"identifier": "31-24906",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FAIRVIEW CARE GIVER ID",
"identifier": "052035",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PATIENT CHOICE",
"identifier": "109962",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2105760",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U CARE",
"identifier": "101069",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA-PRIMARY",
"identifier": "31-74533",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "370010935",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "629885100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1009162",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30852900",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP13656",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0506212",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO",
"identifier": "768184",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "2T289KA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.