NPIMap

Individual provider Active NPI

Kyle Alden Menzel, M.D.

  • Orthopaedic Surgery Physician
  • Cloquet, MN
National Provider Identifier
1780650317
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
53101 Issued in MN
Practice address
Community Memorial Hospital
512 Skyline Boulevard
Cloquet, MN 55720-1199
Phone
(218) 879-4641
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 40774-020 WI
Orthopaedic Surgery Physician 207X00000X 53101 MN Primary

Addresses

Primary practice location

Community Memorial Hospital
512 Skyline Boulevard
Cloquet, MN 55720-1199

Mailing address

Community Memorial Hospital
512 Skyline Boulevard
Cloquet, MN 55720-1199
Phone (218) 879-4641

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hisdept@direct.cloquethospital.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101130001360 MN Practitioner - Orthopedic Surgery 7012082381 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical College of Wisconsin, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
Community Memorial Hospital AssociationGroup PAC ID 0042129991, 47 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

512 Skyline Blvd
Cloquet, MN 55720-3787
Phone (218) 879-4641

Hospital & facility affiliations

  • Community Memorial Hospital Hospital, Cloquet, MN, CCN 241364
  • Cook Hospital Hospital, Cook, MN, CCN 241312
  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047
  • Essentia Health Virginia Hospital, Virginia, MN, CCN 240084
  • Community Memorial Hospital Nursing home, CCN 24Z364

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement11
Knee replacement11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40774-020WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Itasca Hospital District Current Accepting new patients
Community Memorial Hospital Association CurrentSince Feb 1, 2016 Accepting new patients

Locations

512 Skyline Blvd
Cloquet, MN 55720
Phone (218) 878-7207

10 5th St SE
Cook, MN 55723
Phone (218) 626-3441

Interoperability endpoints

  • Direct secure messaging: hisdept@direct.cloquethospital.com

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.

Hospital & facility affiliations 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1780650317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COMMUNITY MEMORIAL HOSPITAL",
            "address_2": "512 SKYLINE BOULEVARD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201199",
            "telephone_number": "218-879-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COMMUNITY MEMORIAL HOSPITAL",
            "address_2": "512 SKYLINE BOULEVARD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201199",
            "telephone_number": "218-879-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENZEL",
        "first_name": "KYLE",
        "middle_name": "ALDEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "40774-020",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "53101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hisdept@direct.cloquethospital.com",
            "affiliation": "N",
            "address_1": "Community Memorial Hospital",
            "address_2": "512 Skyline Boulevard",
            "city": "Cloquet",
            "state": "MN",
            "country_code": "US",
            "postal_code": "557201199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

Verify at the official NPI Registry.