Individual provider Active NPI

Priyanka Kanakamedala, M.D.

  • Ophthalmology Physician
  • Edina, MN
National Provider Identifier
1790104974
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
63807 Issued in MN
Practice address
7450 France Ave S Ste 100
Edina, MN 55435-4799
Phone
(612) 999-2020
Fax
(763) 421-0730
NPI assigned
Apr 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 63807 MN Primary

Addresses

Primary practice location

7450 France Ave S Ste 100
Edina, MN 55435-4799

Mailing address

7450 France Ave S Ste 100
Edina, MN 55435-4799
Phone (612) 999-2020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pkanakamedala18896@direct.ceenta.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180608002352 MN Practitioner - Ophthalmology 4789990474 Reassigns benefits to 2 organizations
I20220706002156 WI Practitioner - Ophthalmology 4789990474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Indiana University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Croix Regional Medical CenterGroup PAC ID 9335032184, 131 clinicians

Practice addresses (Care Compare)

12375 Lindstrom LN
Lindstrom, MN 55045-9551
Phone (651) 400-2240

235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221

3777 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433-2630
Phone (763) 421-7420

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.52 of 100Reported as group
Quality
80.37
Promoting interoperability
96
Improvement activities
40
Cost
74.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery56

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Regional Medical Center CurrentSince Apr 1, 2022 Accepting new patients
Edina Eye Physicians and Surgeons PA Ophthalmology Current Accepting new patients
St. Croix Regional Medical Center CurrentSince Apr 1, 2022 Accepting new patients
Edina Eye Physicians and Surgeons PA Ophthalmology CurrentSince Nov 1, 2021 Accepting new patients
Edina Eye Physicians and Surgeons PA Ophthalmology Past Accepting new patients
St. Croix Regional Medical Center Past Accepting new patients

Locations

11855 Ulysses St NE
Ste 140
Blaine, MN 55434
Phone (763) 421-7420

7450 France Ave S
Ste 100
Minneapolis, MN 55435
Phone (952) 832-8100

3777 Coon Rapids Blvd NW
Ste 100
Minneapolis, MN 55433
Phone (763) 421-7420

216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426

235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221

Interoperability endpoints

  • Direct secure messaging: pkanakamedala397683@excellian.direct.allina.com

Organizations & group practices 6

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 1

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1790104974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 FRANCE AVE S STE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354799",
            "telephone_number": "612-999-2020",
            "fax_number": "763-421-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 FRANCE AVE S STE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354799",
            "telephone_number": "612-999-2020",
            "fax_number": "763-421-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAKAMEDALA",
        "first_name": "PRIYANKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "63807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pkanakamedala18896@direct.ceenta.com",
            "affiliation": "N",
            "address_1": "601 Sutton Rd S Ste 201",
            "city": "Fort Mill",
            "state": "SC",
            "country_code": "US",
            "postal_code": "297158439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.