Keith J Edinburgh

Diagnostic Radiology North Memorial Health Hospital NPI1518967645

Summary

About

Keith J Edinburgh specialises in Diagnostic Radiology. He currently works at North Memorial Health Hospital in Minnesota and has affiliate with 2 other institutions.

Provider Details

NPI Number 1518967645
Provider Name Keith J Edinburgh
Credential MD
Specialization Diagnostic Radiology
Medical School Name Perelman School Of Med At The University Of Pennsylvania
Graduation Year 1992
Gender M
Entity Type Individual
PAC ID by PECOS 4981693611
Professional Enrollment ID I20040508000214
Enumeration Date 07/29/2005
Last Update Date 03/03/2009

Contact Details

Business Practice address 3300 OAKDALE AVE N, Robbinsdale,
55422-2926 Minnesota View on Google Map
Business Practice phone 763-559-2171
Business Practice fax 763-694-9000
Mailing address 2800 CAMPUS DR, Plymouth,
55441-2645 Minnesota View on Google Map
Other phone 763-559-2171
Other fax 763-694-9000
Email Address shannonfig@domain.com Reval Email Address
Incorrect information? Update the NPI Details for Keith J Edinburgh MD Update NPI

Hospital Affilitation

North Memorial Health Hospital in Robbinsdale

Robbinsdale, Minnesota

Maple Grove Hospital

Centracare Health - Monticello

Education & Training

Perelman School Of Med At The University Of Pennsylvania

Diagnostic Radiology, 1992

Group Affiliation

Organization Name PECOS PAC ID Members
Minnesota Diagnostic Imaging Partners Llc 5890681209 24
Minneapolis Radiology Associates Ltd 5698661007 54

Public Reporting for Performance Scores

More Details

Final MIPS Score

60 out of 100

Score Breakdown

Quality Category Score 0
PI Category Score 0

 

IA Category Score 0
Cost Category Score 0
Total Patients: 124
Source of Scores: individual
Newsletter for Healthcare Professionals

Provider Taxonomy Details

Primary Taxonomy
Taxonomy
License No.
41611 (Minnesota)
Provider Taxonomy 2
Taxonomy
License No.
41611 (Minnesota)
Provider Taxonomy 3
Taxonomy
License No.
41611 (Minnesota)
Provider Taxonomy 4
Taxonomy
License No.
41611 (Minnesota)

Reference NPI Information (as per NPPES NPI Record)

Field Name Field Value
NPI 1518967645
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor N
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) Edinburgh
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name Keith
The first name of the provider, if the provider is an individual.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address 2800 CAMPUS DR
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name Plymouth
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name Minnesota
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 55441-2645
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider Business Mailing Address Telephone Number 763-559-2171
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
Provider Business Mailing Address Fax Number 763-694-9000
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider First Line Business Practice Location Address 3300 OAKDALE AVE N
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name Robbinsdale
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name Minnesota
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 55422-2926
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 763-559-2171
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 763-694-9000
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date 07/29/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 03/03/2009
The date that a record was last updated or changed.
Provider Gender Code M
The code designating the provider's gender if the provider is a person.
Provider Gender Male
The provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code #1 2085R0202X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Healthcare Provider Taxonomy #1
Provider License Number 1 41611
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1 MN
Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch 1 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code #2 2085U0001X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 2 A Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound.
Healthcare Provider Taxonomy #2
Provider License Number 2 41611
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2 MN
Provider License Number State Code #2
Healthcare Provider Primary Taxonomy Switch 2 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code #3 2085B0100X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 3 A Radiology doctor of Osteopathy that specializes in Body Imaging.
Healthcare Provider Taxonomy #3
Provider License Number 3 41611
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 3 MN
Provider License Number State Code #3
Healthcare Provider Primary Taxonomy Switch 3 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code #4 2085N0904X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 4 A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the administration of radionuclides and radiolabeled substances for the treatment of disease.
Healthcare Provider Taxonomy #4
Provider License Number 4 41611
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 4 MN
Provider License Number State Code #4
Healthcare Provider Primary Taxonomy Switch 4 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.