Active NPI
Midwest Radiology, PA
- Diagnostic Radiology Physician
- Roseville, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 43
- 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, 2021
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 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 identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 435710800 | Medicaid | MN |
Other names 1
- St. Paul Radiology, PA
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, ID
Enrollment records 31
National Provider Directory
National Provider DirectoryLocations
166 4th St E
Saint Paul, MN 55101
Phone (651) 292-2009
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
1687 Woodlane Dr
Woodbury, MN 55125
Phone (651) 209-6685
2820 19th Ave S
Grand Forks, ND 58201
Phone (701) 772-1610
819 Ash St
Spooner, WI 54801
Phone (715) 635-2111
550 Martin Ave W
Turtle Lake, WI 54889
Phone (715) 986-4101
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.
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": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MN",
"license": "43",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "435710800",
"state": "MN"
}
],
"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.