DR. MITIKA KANABAR – Addiction Medicine (Internal Medicine) Physician, NPI 1154616324

DR. MITIKA KANABAR is a healthcare provider. based in Minneapolis, Minnesota. specializing in FAMILY PRACTICE, INTERNAL MEDICINE. They hold a License No. A132664 (CA). The NPI Number for DR. MITIKA KANABAR is 1154616324

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. MITIKA KANABAR
NPI
1154616324
Phone
(612) 545-9000
Address
2810 NICOLLET AVE
Enumeration Date
15 June 2011
Last Update Date
9 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6619512826
Graduation Year
2006 (20 years ago)
PAC ID
1557631678
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20170724001264
Address ID
CA935342714LA44444WXXX400

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness85
Years active:14State licenses:1Other namesUpdated within 12 months

3,075 FAMILY PRACTICE in MN

Provider Addresses for DR. MITIKA KANABAR

  • 2810 NICOLLET AVE

    MINNEAPOLIS, MN 554084708

    Phone: (612) 545-9000

    Type: Mailing

  • 701 PARK AVE

    FAMILY MEDICINE, HENNEPIN COUNTY MED CENTER

    MINNEAPOLIS, MN 554151623

    Phone: (612) 545-9000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-07-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170724001264IFamily PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55408)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

What number should I use to identify DR. MITIKA KANABAR for billing?
Administrative and clinical systems typically use NPI 1154616324 for DR. MITIKA KANABAR.
Is DR. MITIKA KANABAR's NPI status active today?
Active status means DR. MITIKA KANABAR's NPI record is not deactivated in the public file.
Which specialty label fits DR. MITIKA KANABAR?
NPPES ties DR. MITIKA KANABAR to Addiction Medicine (Internal Medicine) Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. MITIKA KANABAR?
DR. MITIKA KANABAR shows a connection to Minneapolis, Minnesota in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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