Individual provider Active NPI

Kristin Marie Kirsch, M.D.

  • Family Medicine Physician
  • Rochester, MN
National Provider Identifier
1891770459
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46019 Issued in MN
Practice address
2222 18TH Ave NW
Rochester, MN 55901
Phone
(651) 287-0185
Fax
(507) 258-4020
NPI assigned
Dec 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 46019 MN
Internal Medicine Physician 207R00000X 46019 MN
Family Medicine Physician 207Q00000X 46019 MN Primary

Addresses

Primary practice location

2222 18TH Ave NW
Rochester, MN 55901

Mailing address

2222 18TH Ave NW
Rochester, MN 55901-7724
Phone (651) 287-0185

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

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
I20040504001219 MN Practitioner - Family PracticePractitioner - Hospice/Palliative Care 7214925619 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46019MNMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespark Medical Group, PA Internal Medicine CurrentSince Mar 11, 2024 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 1, 2013 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 1, 2013 Accepting new patients

Locations

810 W Main St
Adams, MN 55909
Phone (507) 582-3263

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

5320 W 23rd St
Ste 130
St Louis Park, MN 55416
Phone (952) 345-3213

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ridgeview HospiceWaconia, MN, CCN 241567 Hospice Corporate Director Mar 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1891770459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 18TH AVE NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559017724",
            "telephone_number": "651-287-0185",
            "fax_number": "507-258-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 18TH AVE NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55901",
            "telephone_number": "651-287-0185",
            "fax_number": "507-258-4020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "fax_number": "507-284-0702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRSCH",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "MN",
            "license": "46019",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "46019",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "46019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.