Individual provider Active NPI

Edith H Kang, MD

  • Diagnostic Radiology Physician
  • Roseville, MN
National Provider Identifier
1720066848
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
36166 Issued in MN
Practice address
2355 Highway 36 W
Ste 100
Roseville, MN 55113-3905
Phone
(651) 292-2000
NPI assigned
Jan 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 36166 MN Primary

Addresses

Primary practice location

2355 Highway 36 W
Ste 100
Roseville, MN 55113-3905

Mailing address

2355 Highway 36 W
Ste 100
Roseville, MN 55113-3905
Phone (651) 292-2000

Other identifiers 1

IdentifierTypeStateIssuer
784263500MedicaidMN

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
I20080602000052 MN Practitioner - Diagnostic Radiology 9032023726 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
Towner County Medical Center Inc CurrentSince Sep 11, 2015 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
Fairview Health Services CurrentSince Jul 15, 2019 Accepting new patients
Group Health, Inc. Current Accepting new patients
Christian Unity Hospital Corporation Past Accepting new patients
Consulting Radiologists, LTD Diagnostic Radiology PastSince Mar 1, 2019 Accepting new patients

Locations

6545 France Ave S
Ste 125
Edina, MN 55435
Phone (952) 405-2777

1650 Beam Ave
Maplewood, MN 55109
Phone (651) 221-9051

2945 Hazelwood St
Ste 110
Maplewood, MN 55109

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

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

2355 Highway 36 W
Ste 100
Saint Paul, MN 55113
Phone (651) 292-0000

166 4th St E
Saint Paul, MN 55101
Phone (651) 292-2009

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

166 4th St E
Ste 100
Saint Paul, MN 55101

2251 Connecticut Ave S
Sartell, MN 56377
Phone (320) 253-5220

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1720066848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W",
            "address_2": "STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W",
            "address_2": "STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "EDITH",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "36166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "784263500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.