MEDICARE: KIMBERLEE ANN THIELEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	34968	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	110130174	OTHER	MN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3113111	OTHER	MN	MEDICA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	HP20119	OTHER	MN	HEALTHPARTNERS
5	IM1772	OTHER	MN	AMERICA'S PPO
6	110385C028	OTHER	MN	UCARE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	01T58TH	OTHER	MN	BCBSMN
9	1011156	OTHER	MN	PREFERRED ONE

General Provider Information

NPI Number	:	1356362164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLEE ANN THIELEN M.D.

Provider Business Mailing Address
First Line	:	6200 SHINGLE CREEK PKWY STE 260
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-2128
Country	:	US
Telephone Number	:	763-561-5349
Fax Number	:

Provider Business Practice Location Address
First Line	:	6601 LYNDALE AVE S
Second Line	:	SUITE 220
City	:	RICHFIELD
State	:	MN
Zip	:	55423-2477
Country	:	US
Telephone Number	:	612-823-8001
Fax Number	:	612-823-1010

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	01/15/2026

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