Organization Active NPI

Midwest Radiology, PA

  • Diagnostic Radiology Physician
  • Roseville, MN
National Provider Identifier
1952307175
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
43 Issued in MN
Legal business name
MIDWEST RADIOLOGY, PA
Practice address
2355 Hwy 36 W.
Ste. 100
Roseville, MN 55113-3905
Phone
(651) 292-2000
NPI assigned
Jun 22, 2005
Last updated
May 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Authorized official

Name
See Yang
Title
Credentialing Manager
Phone
(651) 292-2013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 43 MN Primary

Addresses

Primary practice location

2355 Hwy 36 W.
Ste. 100
Roseville, MN 55113-3905

Mailing address

2355 Highway 36 W Ste 100
Roseville, MN 55113-3905
Phone (651) 292-2000

Other names 1

  • St. Paul Radiology, PA Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI, ND, IA, CO, TN, AZ, NC, SC, UT, CA, WV, MO, MI, WA, RI, NV, OH, IN, DC, TX, KY, FL, PA, OR, GA, AL, IL, ME, MA, ID31 enrollments

Enrollment records 31

Enrollment IDStateProvider typePAC IDDetails
O20031114000105 MN Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 214 practitioners
Practice locations: Redwood Falls, MN; Maplewood, MN; Roseville, MN; Saint Paul, MN; Stillwater, MN; Willmar, MN; Woodbury, MN; Wyoming, MN…
O20040126000027 WI Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 193 practitioners
Practice locations: Baldwin, WI; Saint Croix Falls, WI; River Falls, WI; Osceola, WI; Hudson, WI; New Richmond, WI; Amery, WI
O20040803000350 ND Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Bismarck, ND
O20051116001045 IA Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 2 practitioners
Practice locations: Cumming, IA; West Des Moines, IA
O20180808002733 CO Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 4 practitioners
Practice locations: Denver, CO; Evergreen, CO; Parker, CO
O20191231002331 TN Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Franklin, TN
O20200107002099 AZ Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 4 practitioners
Practice locations: Cottonwood, AZ; Mesa, AZ; Peoria, AZ; Scottsdale, AZ
O20200219002091 NC Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 2 practitioners
Practice locations: Cornelius, NC; Concord, NC
O20200407002890 SC Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Pleasant, SC
O20211104001464 UT Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Sandy, UT
O20220103000832 CA Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 5 practitioners
Practice locations: Cerritos, CA; Santa Barbara, CA; San Diego, CA; La Crescenta, CA; Cloverdale, CA
O20220126002653 WV Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Falling Waters, WV
O20220127002776 MO Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO
O20220223002207 MI Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 4 practitioners
Practice locations: Ann Arbor, MI; Troy, MI; Champion, MI
O20220725003154 WA Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 6 practitioners
Practice locations: Seattle, WA; Mercer Island, WA; Kirkland, WA; Gig Harbor, WA
O20220831002452 RI Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: West Greenwich, RI
O20221013000309 NV Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Carson City, NV
O20221018001763 OH Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 2 practitioners
Practice locations: Aurora, OH; Columbus, OH
O20230508000759 IN Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 3 practitioners
Practice locations: Fishers, IN; Indianapolis, IN
O20230624000008 DC Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, DC
O20230724002061 TX Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 3 practitioners
Practice locations: Plano, TX; Richmond, TX; Parker, TX
O20240125001641 KY Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY
O20240530000810 FL Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 6 practitioners
Practice locations: Sarasota, FL; Oviedo, FL; Nokomis, FL; Key Biscayne, FL; Longboat Key, FL; Estero, FL
O20240724000077 PA Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Pittsburgh, PA
O20241220003545 OR Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 2 practitioners
Practice locations: Portland, OR
O20250131000491 GA Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Roswell, GA
O20250321002127 AL Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 2 practitioners
Practice locations: Huntsville, AL; Mountain BRK, AL
O20250904002457 IL Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 2 practitioners
Practice locations: Lisle, IL; Morton Grove, IL
O20251110002813 ME Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: South Portland, ME
O20260407004034 MA Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Boston, MA
O20260513002078 ID Part B Supplier - Clinic/Group Practice 4486568482 Receives reassigned benefits from 1 practitioner
Practice locations: Idaho Falls, ID

National Provider Directory

National Provider Directory

Locations

407 E 3rd St
Duluth, MN 55805
Phone (218) 786-4357

1185 Town Centre Dr
Ste 100
Eagan, MN 55123
Phone (651) 968-5230

1175 Nininger Rd
Hastings, MN 55033
Phone (651) 404-1000

190 5th St E
Ste 250
Saint Paul, MN 55101
Phone (612) 228-9155

250 Thompson St
Saint Paul, MN 55102
Phone (651) 297-6504

400 Wabasha St N
Ste 260
Saint Paul, MN 55102
Phone (952) 977-3500

401 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-7580

514 Saint Peter St
Ste 100
Saint Paul, MN 55102
Phone (651) 726-6500

301 Mountain St E
Cavalier, ND 58220
Phone (701) 265-6307

Practitioners & affiliated clinicians

Practitioners 281

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 281

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621987200000",
    "number": "1952307175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HWY 36 W.",
            "address_2": "STE. 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST RADIOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "SEE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "651-292-2013"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "43",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Paul Radiology, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.