Individual provider Active NPI

Kathleen Hickey Puls

  • Audiologist
  • Minneapolis, MN
National Provider Identifier
1851473300
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
5252 Issued in MN
Practice address
2211 Park Ave
Minneapolis, MN 55404-3711
Phone
(612) 871-1144
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 5252 MN Primary

Addresses

Primary practice location

2211 Park Ave
Minneapolis, MN 55404-3711

Mailing address

15572 Ranchview CT
Wayzata, MN 55391-1403
Phone (952) 404-0915

Other names 1

  • Kathleen Marie Hickey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081111000136 MN Practitioner - Qualified Audiologist 6608935317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Wisconsin School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Specialty Care of Minnesota PAGroup PAC ID 3274524020, 46 clinicians

Practice addresses (Care Compare)

6099 Wayzata Blvd
Suite 200
St Louis Park, MN 55416-5538
Phone (612) 871-1144

6525 France Ave S
Suite 325
Edina, MN 55435-2187
Phone (612) 871-1144

9822 Hospital Dr
Maple Grove, MN 55369-4648
Phone (612) 871-1144

Merit-based Incentive Payment System (MIPS)

Final score
77.11 of 100Reported as group
Quality
63.28
Promoting interoperability
91
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
5252MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose & Throat Specialty Care of Minnesota PA CurrentSince Oct 1, 2008 Accepting new patients

Locations

9550 Upland Ln N
Ste 200
Maple Grove, MN 55369
Phone (612) 871-1144

9822 Hospital Dr
Maple Grove, MN 55369
Phone (612) 871-1144

2211 Park Ave
Minneapolis, MN 55404
Phone (612) 871-1144

6099 Wayzata Blvd
Ste 200
St Louis Park, MN 55416
Phone (612) 871-1144

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1851473300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15572 RANCHVIEW CT",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911403",
            "telephone_number": "952-404-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043711",
            "telephone_number": "612-871-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULS",
        "first_name": "KATHLEEN",
        "middle_name": "HICKEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "5252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "HICKEY",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.