NPIMap

Individual provider Active NPI

James Elton Kuderer, D.O.

  • Otolaryngology Physician
  • St Louis Park, MN
National Provider Identifier
1972748119
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
56609 Issued in MN
Practice address
3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone
(952) 993-3250
NPI assigned
Dec 2, 2008
Last updated
Dec 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 56609 MN Primary

Addresses

Primary practice location

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527

Mailing address

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131114000915 MN Practitioner - Otolaryngology 2365688017 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians
Oakdale Ear, Nose and Throat Clinic, P.a.Group PAC ID 9133209802, 12 clinicians

Practice addresses (Care Compare)

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700

3366 Oakdale Ave N
Suite 150
Robbinsdale, MN 55422-2961
Phone (763) 233-5755

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3900 Park Nicollet Blvd
St Louis Park, MN 55416-2503
Phone (952) 993-3123

400 E 1St St
Morris, MN 56267-1408
Phone (320) 589-1313

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision24

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin Healthcare System, Inc Current Accepting new patients
Park Nicollet Clinic CurrentSince Sep 3, 2013 Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Sep 3, 2013 Accepting new patients
Stevens Community Medical Center Inc CurrentSince Feb 1, 2023 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Jul 30, 2022 Accepting new patients
Stevens Community Medical Center Inc. Current Accepting new patients
Oakdale Ear, Nose & Throat Clinic, P.a. Otolaryngology CurrentSince Dec 5, 2023 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Jul 30, 2022 Accepting new patients
Stevens Community Medical Center Inc CurrentSince Feb 1, 2023 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Minneapolis Radiology Associates, LTD. PastSince Dec 5, 2023 Accepting new patients

Locations

9825 Hospital Dr
Ste 203
Maple Grove, MN 55369
Phone (763) 233-5750

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

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

8301 Golden Valley Rd
Ste 200
Minneapolis, MN 55427
Phone (763) 233-5755

400 E 1st St
Morris, MN 56267
Phone (320) 589-1313

3366 Oakdale Ave N
Ste 150
Robbinsdale, MN 55422
Phone (763) 233-5755

3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 993-1000

Interoperability endpoints

  • Direct secure messaging: jkuderer156765@direct.healthpartners.com
  • Direct secure messaging: jkuderer660545@direct.centracare.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1972748119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-993-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDERER",
        "first_name": "JAMES",
        "middle_name": "ELTON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-02",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "56609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.