Individual provider Active NPI

Monica Katherine Kimitch, AU.D. CCC-A

  • Audiologist
  • Woodbury, MN
National Provider Identifier
1902034069
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
8354 Issued in MN
Practice address
2080 Woodwinds Dr Ste 240
Woodbury, MN 55125-2539
Phone
(651) 702-0750
Fax
(651) 645-6166
NPI assigned
Jun 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 8354 MN Primary

Addresses

Primary practice location

2080 Woodwinds Dr Ste 240
Woodbury, MN 55125-2539

Mailing address

2080 Woodwinds Dr Ste 240
Woodbury, MN 55125-2539
Phone (651) 702-0750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120718000142 MN Practitioner - Qualified Audiologist 6305002411 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin Healthcare System Inc CurrentSince Dec 1, 2014 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Dec 1, 2014 Accepting new patients
Hennepin Faculty Associates Past Accepting new patients

Locations

715 S 8th St
Minneapolis, MN 55404
Phone (612) 873-6010

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

701 Park Ave
#350
Minneapolis, MN 55415
Phone (612) 873-5334

Organizations & group practices 4

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": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1902034069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 WOODWINDS DR STE 240",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252539",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 WOODWINDS DR STE 240",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252539",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMITCH",
        "first_name": "MONICA",
        "middle_name": "KATHERINE",
        "credential": "AU.D. CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "8354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.