NPIMap

Individual provider Active NPI

Andrew George Keenan, M.D.

  • Hospitalist Physician
  • Duluth, MN
National Provider Identifier
1821239161
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
53598 Issued in MN
Practice address
Essentia Health Duluth Clinic
400 East Third Street
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
Mar 17, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD7497 AK
Hospitalist Physician 208M00000X 53598 MN Primary

Addresses

Primary practice location

Essentia Health Duluth Clinic
400 East Third Street
Duluth, MN 55805-1951

Mailing address

420 Delaware St. SE
MMC 276
Minneapolis, MN 55455

Other practice location 1

420 Delaware St. SE
MMC 276
Minneapolis, MN 55455
Phone (612) 624-8984

Other identifiers 2

IdentifierTypeStateIssuer
MD9366MedicaidAK
K164680OtherAKMEDICARE

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
I20131025000200 MN Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Hospitalist 6103078795 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Hospitalist, Internal Medicine
Education
Medical College of Wisconsin, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD7497AKMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Essentia Health Virginia, LLC CurrentSince Apr 11, 2018 Accepting new patients
The Duluth Clinic LTD CurrentSince Oct 1, 2021 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Oct 1, 2021 Accepting new patients
Essentia Health Virginia, LLC CurrentSince Apr 11, 2018 Accepting new patients
Fairview Health Services CurrentSince Aug 16, 2013 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Northern Hospital Associates LLC Hospitalist PastSince Jan 1, 2013 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

2501 Keenan Dr
Intl Falls, MN 56649
Phone (218) 283-4481

420 Delaware St SE
#276
Minneapolis, MN 55455
Phone (612) 624-0999

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

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

Organizations & group practices 10

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 10

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": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1821239161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST. SE",
            "address_2": "MMC 276",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ESSENTIA HEALTH DULUTH CLINIC",
            "address_2": "400 EAST THIRD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Delaware St. SE",
            "address_2": "MMC 276",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55455",
            "country_code": "US",
            "telephone_number": "612-624-8984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "ANDREW",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AK",
            "license": "MD7497",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "53598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD9366",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K164680",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.