NPIMap

Individual provider Active NPI

Anthony A Killeen, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1811087323
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
30034 Issued in MN
Practice address
420 Delaware Street SE
760 Mayo Memorial Building
Minneapolis, MN 55455
Phone
(612) 625-5443
Fax
(612) 625-1121
NPI assigned
Oct 13, 2006
Last updated
May 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Molecular Genetic Pathology (Pathology) Physician 207ZP0007X 30034 MN
Chemical Pathology Physician 207ZP0104X 30034 MN
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 30034 MN Primary

Addresses

Primary practice location

420 Delaware Street SE
760 Mayo Memorial Building
Minneapolis, MN 55455

Mailing address

420 Delaware St SE MMC 609
University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 625-5443

Other identifiers 7

IdentifierTypeStateIssuer
1031950OtherMNPREFERRED ONE
11-00014OtherMNMEDICA-PRIMARY
11-00232OtherMNMEDICA-CHOICE
HP38352OtherMNHEALTH PARTNERS
102788OtherMNU CARE
041657600MedicaidMN
1696864OtherARAZ

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
I20071010000608 MN Practitioner - Pathology 5092801787 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (800) 468-3120

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
91.74
Promoting interoperability
100
Improvement activities
40
Cost
77.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30034MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Feb 22, 2016 Accepting new patients
Fairview Health Services Clinical Pathology/Laboratory Medicine Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Feb 22, 2016 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Oct 22, 2021 Accepting new patients
Fairview Express Care CurrentSince Nov 13, 2009 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Feb 11, 2023 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Mar 6, 2019 Accepting new patients
Fairview Health Services CurrentSince Nov 13, 2009 Accepting new patients
Fairview Express Care CurrentSince Mar 6, 2019 Accepting new patients
Fairview Clinics CurrentSince Oct 22, 2021 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 1, 2002 Accepting new patients
University of Minnesota Pediatric Dental Clinic CurrentSince Jul 1, 2002 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

420 Delaware St SE
#609
Minneapolis, MN 55455
Phone (612) 624-8133

420 Delaware St SE
#760
Minneapolis, MN 55455
Phone (612) 626-0622

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

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

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

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0331

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

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

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 9

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1811087323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE MMC 609",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-625-5443",
            "fax_number": "612-625-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE STREET SE",
            "address_2": "760 MAYO MEMORIAL BUILDING",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-625-5443",
            "fax_number": "612-625-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEEN",
        "first_name": "ANTHONY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0007X",
            "taxonomy_group": "",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": "MN",
            "license": "30034",
            "primary": false
        },
        {
            "code": "207ZP0104X",
            "taxonomy_group": "",
            "desc": "Pathology, Chemical Pathology",
            "state": "MN",
            "license": "30034",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "MN",
            "license": "30034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1031950",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA-PRIMARY",
            "identifier": "11-00014",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA-CHOICE",
            "identifier": "11-00232",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP38352",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE",
            "identifier": "102788",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041657600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "1696864",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.