ANASTASIA K KETKO (NPI# 1548434772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548434772 |
| Entity Type | Individual |
| Full Name | ANASTASIA K KETKO |
| Credential | M.D. |
| Practice Address |
9325 Upland Lane N Suite 360 Maple Grove MN 55369 |
| Practice Telephone | 6128136475 |
| Mailing Telephone | 6128136475 |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2019-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
4301097959 | MI | Allopathic & Osteopathic Physicians |
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
57795 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
9325 UPLAND LANE N SUITE 360 |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881690097 | Minnesota Neonatal Physicians | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2005-06-22 |
| 1316143936 | Spine & Sports Institute | Chiropractor | 9325 Upland Lane N, Suite 230, Maple Grove, MN 55369-4450 | 2007-06-21 |
| 1093932709 | Aaron Wendell Swenson | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2007-04-20 |
| 1891888186 | Jane Elizabeth Barthell | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-10-01 |
| 1720092398 | Nina Rachel Perdue | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-07-28 |
| 1417961319 | Bonnie Gail Landrum | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-07-28 |
| 1861430605 | Thomas B Ferrara | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-06-03 |
| 1144274176 | Jeanne D Mrozek | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-05-22 |
| 1578515300 | Neil P Mulrooney | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982710265 | Erin Clifford Stepka | Pediatrics | 9875 Hospital Drive, Maple Grove Hospital - Scn, Maple Grove, MN 55369 | 2006-08-21 |
| 1881690097 | Minnesota Neonatal Physicians | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2005-06-22 |
| 1255951190 | Minnesota Neonatal Specialists | Pediatrics | 9875 Hospital Dr, Maple Grove, MN 55369-4648 | 2020-04-21 |
| 1891888186 | Jane Elizabeth Barthell | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-10-01 |
| 1720092398 | Nina Rachel Perdue | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-07-28 |
| 1417961319 | Bonnie Gail Landrum | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-07-28 |
| 1861430605 | Thomas B Ferrara | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-06-03 |
| 1144274176 | Jeanne D Mrozek | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-05-22 |
| 1578515300 | Neil P Mulrooney | Pediatrics | 9325 Upland Lane N, Suite 360, Maple Grove, MN 55369 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174882666 | Erin Anne Plummer | Pediatrics | 347 Smith Ave N Ste 505, Saint Paul, MN 55102 | 2012-05-03 |
| 1407000797 | Fredric Kleinberg | Pediatrics | 913 9th Ave Sw, Rochester, MN 55902-6363 | 2008-11-12 |
| 1699838300 | Mark Joseph Bergeron | Pediatrics | Mmc 39 420 Delaware Street Se, University of Minnesota Division of Neonatology, Minneapolis, MN 55455 | 2006-12-18 |
| 1679646228 | Judy Ann Rigby | Pediatrics | 1117 W Skyline Pkwy, Duluth, MN 55806-2326 | 2006-11-15 |
| 1285717082 | Kari Roberts | Pediatrics | Pwb Fourth Floor, Room 4-100, 516 Delaware Street Se, Minneapolis, MN 55455 | 2006-10-23 |
| 1457382475 | Lee Alan Muskovitz | Pediatrics | 13060 Isle Drive, Baxter, MN 56425 | 2006-07-06 |
| 1376023309 | Gianna Maria Braband | Pediatrics | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2018-08-20 |
| 1467967448 | Magdalene Marie Anderson | Pediatrics | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2017-12-12 |
| 1497163653 | Raymond Stetson | Pediatrics | 200 1st St Sw, Rochester, MN 55905-0001 | 2014-07-31 |
| 1679918486 | Abigail Elizabeth Faulman | Pediatrics | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2013-05-07 |
| Find all providers with the same taxonomy | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
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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.