NPIMap

Individual provider Active NPI

Kaikhushroo B Radmanesh, MD

  • Internal Medicine Physician
  • Apple Valley, MN
National Provider Identifier
1871526665
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
43771 Issued in MN
Practice address
14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone
(651) 241-3779
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43771 MN Primary

Addresses

Primary practice location

14655 Galaxie Ave
Apple Valley, MN 55124-8602

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Other identifiers 1

IdentifierTypeStateIssuer
804617400MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kradmanesh87417@excellian.direct.allina.com Direct

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
I20060328000055 MN Practitioner - Internal Medicine 4880602218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone (651) 241-3779

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

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
43771MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Apr 25, 2024 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Apr 25, 2024 Accepting new patients
Regency Hospital of Minneapolis, LLC CurrentSince Aug 8, 2016 Accepting new patients
Group Health, Inc. Past Accepting new patients
Saint Francis Hospital / Medicine Past Accepting new patients
Villas at Bryn Mawr LLC Past Accepting new patients
Villas at Roseville LLC Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

1300 Hidden Lakes Pkwy
Minneapolis, MN 55422
Phone (763) 588-2750

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

1020 Bandana Blvd W
Saint Paul, MN 55108
Phone (651) 641-1000

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

Interoperability endpoints

  • Direct secure messaging: kradmanesh87417@excellian.direct.allina.com

Organizations & group practices 9

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 38

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1871526665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14655 GALAXIE AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248602",
            "telephone_number": "651-241-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADMANESH",
        "first_name": "KAIKHUSHROO",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "43771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804617400",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kradmanesh87417@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "14655 Galaxie Ave",
            "city": "Apple Valley",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551248602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.