Individual provider Active NPI

Kimberly Oelhafen, MD

  • Family Medicine Physician
  • Robbinsdale, MN
National Provider Identifier
1770997439
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
70548 Issued in MN
Practice address
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone
(763) 520-5200
NPI assigned
Jun 19, 2014
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 70548 MN Primary

Addresses

Primary practice location

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Mailing address

4413 James Ave N
Minneapolis, MN 55412-1220
Phone (917) 565-0466

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
I20221007002549 MN Practitioner - Family Practice 6002241361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-0907

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
70548MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care CurrentSince Jul 1, 2022 Accepting new patients
North Memorial Health Care CurrentSince Jul 1, 2022 Accepting new patients
North Memorial Health Care Current Accepting new patients

Locations

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1770997439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4413 JAMES AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121220",
            "telephone_number": "917-565-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-520-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OELHAFEN",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "70548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.