Kevin E Amundson, D.D.S., M.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D8238 Issued in MN

Practice address

3632 10TH LN NW
Rochester, MN 55901-6917

Phone

(507) 281-5000

Fax

(507) 281-5001

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 16, 2017 through May 16, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Mayo Clinic Health System-Southeast Minnesota Region

  • Durable Medical Equipment & Medical Supplies
  • Austin, MN
  • NPI 1265462279
  NPD (past)
• Southeastern Minnesota Oral & Maxillofacial Surgery Associates

  • Oral and Maxillofacial Surgery Clinic/Center
  • Rochester, MN
  • NPI 1659492312
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851329536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 HILLCREST AVE",
            "address_2": "SUITE 130",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550603680",
            "telephone_number": "507-451-0290",
            "fax_number": "507-451-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 10TH LN NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559016917",
            "telephone_number": "507-281-5000",
            "fax_number": "507-281-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "KEVIN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D8238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "0011095",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "117898",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35012AM",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1008932",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Huff Amundsen, MS, LP
• Adam Wayne Amundson, M.D.
• Alyssa Marie Amundson, PT
• Kathryn A Amundson, PHD, LICSW
• Kelly M Amundson, OT
• Miranda An, MD
• Charenya Anandan, M. D.
• Nandan S Anavekar, MBBCH
• Stephanie Anaya, MD
• Luke Nathaniel Andera, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Rochester, MN
• Providers in Rochester, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.