KELLY RENEE DIETZ (NPI# 1295877702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295877702 |
| Entity Type | Individual |
| Full Name | KELLY RENEE DIETZ |
| Credential | MD |
| Practice Address |
516 Delaware Street Se Umphysicians Imaging Center Minneapolis MN 55455-0341 |
| Mailing Address |
720 Washington Ave Se University of Minnesota Physicians Minneapolis MN 55414 |
| Practice Telephone | 6126241500 |
| Mailing Telephone | 6128840649 |
| Mailing Fax Number | 6126768992 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2013-03-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
53312 | MN | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
19422 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
516 DELAWARE STREET SE UMPHYSICIANS IMAGING CENTER |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55455-0341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932193083 | Daniel James Guillaume | Neurological Surgery | 516 Delaware Street Se, Ump Neurosurgery Clinic, Minneapolis, MN 55455 | 2005-09-06 |
| 1194042689 | Amy Ann Mrazek | Surgery | 516 Delaware Street Se, Pwb 11-145e, Mmc 195, Minneapolis, MN 55455 | 2010-04-23 |
| 1932340213 | Daniel Joshua Steinberger | Radiology | 516 Delaware Street Se, Umphysicians Imaging Center, Minneapolis, MN 55455 | 2009-03-16 |
| 1518129071 | Torfi Thorkell Hoskuldsson | Surgery | 516 Delaware Street Se, Ump Surgery Clinic, Minneapolis, MN 55455-0356 | 2008-06-26 |
| 1659407708 | Deanna G.k. Teoh | Obstetrics & Gynecology | 516 Delaware Street Se, Women's Health Center, Minneapolis, MN 55455 | 2007-02-25 |
| 1417031279 | Carrie Kissling | Registered Nurse | 516 Delaware Street Se, Pwb Third Floor, Clinic 3b, Minneapolis, MN 55455 | 2006-10-25 |
| 1295819498 | Anna Petryk | Pediatrics | 516 Delaware Street Se, Pwb Fourth Floor, Room 4-100, Minneapolis, MN 55455 | 2006-10-24 |
| 1972687366 | Jonathan I Ravdin | Internal Medicine | 516 Delaware Street Se, Pwb Sixth Floor, Clinic 6b, Minneapolis, MN 55455 | 2006-10-24 |
| 1588748818 | Michael J Potegal | Clinical Neuropsychologist | 516 Delaware Street Se, Pwb Fourth Floor, Room 4-100, Minneapolis, MN 55455 | 2006-10-24 |
| 1942382452 | Mark Richard Schleiss | Pediatrics | 516 Delaware Street Se, Pwb Fourth Floor, Room 4-100, Minneapolis, MN 55455 | 2006-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715679 | Kara Biscobing | Nurse Anesthetist, Certified Registered | M Health Fairview Ummc East Bank 3-307, 500 Harvard Street, Minneapolis, MN 55455 | 2020-09-18 |
| 1982213237 | Yue Hu | Dentist | 515 Delaware St. Se Malcolm Moos Health Sciences Tower, Room 7-174, Minneapolis, MN 55455 | 2020-07-23 |
| 1952922148 | Jacob Laurence Tigner | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se, Mmc 284, Minneapolis, MN 55455 | 2020-04-29 |
| 1710507538 | Rachael Grundman | Student in an Organized Health Care Education/Training Program | 420 Delaware St, Mmc 395, Minneapolis, MN 55455 | 2020-04-22 |
| 1497375240 | Sanjay Dhawan | Student in an Organized Health Care Education/Training Program | 420 Delaware St. Se, Mmc 195, Minneapolis, MN 55455 | 2020-04-22 |
| 1508486549 | Dariel Andres Diaz | Student in an Organized Health Care Education/Training Program | 420 Se Delaware Street, Mmc 195, Minneapolis, MN 55455 | 2020-04-20 |
| 1275186280 | Kerem Ozturk | Radiology | B-226 Mayo Memorial Building, Mmc 292 420 Delaware Street S.e., Minneapolis, MN 55455 | 2019-07-18 |
| 1275194631 | Andres Jose Gonzalez Coba | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se Mmc 284, Minneapolis, MN 55455 | 2019-06-26 |
| 1841850278 | Brendan Andrew Schleyer | Dentist | 515 Delaware St Se, Div of Periodontology, Moos Tower, 7-368, Minneapolis, MN 55455 | 2019-06-18 |
| 1932767399 | Claire-audrey Y Bayan | Student in an Organized Health Care Education/Training Program | 420 Delaware Street, Mmc 98, Minneapolis, MN 55455 | 2019-05-31 |
| Find all providers in zip 55455 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164765822 | Robben Andrew Schat | Radiology | 420 Delaware St Se - Mmc 292, Minneapolis, MN 55455-0341 | 2013-04-01 |
| 1326363102 | Gilda Boroumand | Radiology | 1901 Irving Ave S, Minneapolis, MN 55403-2824 | 2010-04-05 |
| 1477880276 | Siobhan Moira Flanagan | Radiology | Mmc 292,420 Delaware Street Se, University of Minnesota Department of Radiology, Minneapolis, MN 55455 | 2009-11-16 |
| 1720153075 | Annelisa M Carlson | Radiology | 5228 Evanswood Ln, Minneapolis, MN 55436-1133 | 2006-11-22 |
| 1972600286 | Michael T Nelson | Radiology | Riverside Professional Building, Second Floor, Suite 200, 606 24th Avenue South, Minneapolis, MN 55454 | 2006-09-20 |
| 1073610374 | Carol Coleman Steenson | Radiology | 1 Veterans Drive, Dept of Imaging (114), Minneapolis Va Health Care System, Minneapolis, MN 55417 | 2006-09-20 |
| 1821023342 | Herbert Jones | Radiology | 3508 W 28th St, Minneapolis, MN 55416-4304 | 2006-07-12 |
| 1508816315 | Nazih N Farah | Radiology | 1221 Nicollet Ave, Suite 600, Minneapolis, MN 55403-2420 | 2006-05-11 |
| 1811947500 | Daniel Warren Eurman | Radiology | 100 3rd Ave S Unit 1507, Minneapolis, MN 55401 | 2006-05-11 |
| 1114906872 | David C Swanson | Radiology | 701 Park Ave # P4, Hcmc Radiology, Minneapolis, MN 55415-1623 | 2006-01-11 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55455 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.