Individual provider Active NPI

Ryan Kelly, M.D.

  • Internal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1881820074
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56348 Issued in MN
Practice address
2001 Bloomington Avenue S
Minneapolis, MN 55404-3074
Phone
(612) 301-3433
NPI assigned
Jun 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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 56348 MN Primary

Addresses

Primary practice location

2001 Bloomington Avenue S
Minneapolis, MN 55404-3074

Mailing address

420 Delaware St SE
MMC 741
Minneapolis, MN 55455-0341
Phone (612) 624-8984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140707000823 MN Practitioner - Internal MedicinePractitioner - Pediatric Medicine 0446475495 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Wayne State University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of MinnesotaGroup PAC ID 7416856059, 36 clinicians
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

2001 Bloomington Ave S
Minneapolis, MN 55404-3074

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 625-3600

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56348MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota CurrentSince Aug 29, 2014 Accepting new patients
Fairview Specialty Services CurrentSince Apr 12, 2022 Accepting new patients
Fairview Clinics CurrentSince Mar 8, 2020 Accepting new patients
Healtheast St. John'S Hospital CurrentSince Mar 8, 2020 Accepting new patients
Healtheast Medical Research Institute Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Apr 12, 2022 Accepting new patients
Fairview Clinics CurrentSince Mar 8, 2020 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Mar 8, 2020 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Jul 4, 2020 Accepting new patients
Healtheast Care System CurrentSince Mar 8, 2020 Accepting new patients
Fairview Express Care CurrentSince Jul 4, 2020 Accepting new patients
Fairview Bethesda Hospital CurrentSince Mar 8, 2020 Accepting new patients
Regents of the University of Minnesota CurrentSince Aug 29, 2014 Accepting new patients
Fairview Express Care Current 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

19685 Pilot Knob Rd
Farmington, MN 55024
Phone (651) 463-5100

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

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

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

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

2001 Bloomington Ave
Minneapolis, MN 55404
Phone (612) 301-3433

2025 E River Rd
Minneapolis, MN 55414
Phone (612) 301-0115

2312 S 6th St
Ste F105
Minneapolis, MN 55454
Phone (612) 273-3565

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

2312 S 6th St
Ste 105
Minneapolis, MN 55454
Phone (612) 273-5530

420 Delaware St SE
#741
Minneapolis, MN 55455
Phone (612) 624-8984

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

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

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

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

3305 Central Park Village Dr
Ste 200
Saint Paul, MN 55121
Phone (651) 406-8860

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: rkelly5196@fairview.direct-ci.com
  • Direct secure messaging: rkelly290921@direct.ochin.org

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 3

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": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1881820074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 741",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-624-8984",
            "fax_number": "612-624-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BLOOMINGTON AVENUE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043074",
            "telephone_number": "612-301-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-02",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "56348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.