Individual provider Active NPI

Kirk Leslie Scofield, MD

  • Sports Medicine (Family Medicine) Physician
  • Vadnais Heights, MN
National Provider Identifier
1972573566
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
54590 Issued in MN
Practice address
3580 Arcade St
Vadnais Heights, MN 55127-7135
Phone
(651) 968-5770
Fax
(651) 968-5775
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4381 AK
Sports Medicine (Family Medicine) Physician 207QS0010X 54590 MN Primary

Addresses

Primary practice location

3580 Arcade St
Vadnais Heights, MN 55127-7135

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5042

Other identifiers 1

IdentifierTypeStateIssuer
MD4391MedicaidAK

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
I20120716000130 MN Practitioner - Sports Medicine 1658312442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
University of Washington School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

1661 Saint Anthony Ave
Saint Paul, MN 55104-3733
Phone (651) 968-5201

2090 Woodwinds Dr
Saint Paul, MN 55125-2522
Phone (651) 968-5201

2620 Eagan Woods Dr
Eagan, MN 55121-1138
Phone (651) 968-5201

3580 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 968-5201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4381AKMDFamily Medicine Physician
54590MNMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Orthopedics LTD Current Accepting new patients
Summit Orthopedics LTD CurrentSince Aug 15, 2012 Accepting new patients
Summit Orthopedics, LTD CurrentSince Aug 15, 2012 Accepting new patients
Ilbnc, P.a. Past Accepting new patients
Summit Orthopedics, LTD. Past Accepting new patients
Summit Orthopedics, LTD. Past Accepting new patients

Locations

10230 Baltimore St NE
#300
Blaine, MN 55449
Phone (651) 968-5300

17210 Kenyon Ave
Lakeville, MN 55044
Phone (651) 968-5960

1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5300

1661 Saint Anthony Ave
Fl 1
Saint Paul, MN 55104
Phone (651) 968-5600

2620 Eagan Woods Dr
Saint Paul, MN 55121
Phone (651) 968-5142

3580 Arcade St
Vadnais Heights, MN 55127
Phone (651) 968-5600

4123 Radio Dr
Woodbury, MN 55129
Phone (651) 968-5300

2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5801

710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042

Interoperability endpoints

  • Direct secure messaging: kirklscofield@sol.allscriptsdirect.net

Organizations & group practices 6

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.

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1972573566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5042",
            "fax_number": "651-968-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 ARCADE ST",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551277135",
            "telephone_number": "651-968-5770",
            "fax_number": "651-968-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOFIELD",
        "first_name": "KIRK",
        "middle_name": "LESLIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "4381",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MN",
            "license": "54590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD4391",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vadnais Heights, MN

Sources for this page

Verify at the official NPI Registry.