KETAN DAVAE (MD) – Diagnostic Radiology Physician, NPI 1700838620

KETAN DAVAE (MD) is a healthcare provider. based in Eden prairie, Minnesota. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials MD. They hold a License No. MD.204391 (LA). The NPI Number for KETAN DAVAE (MD) is 1700838620

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
KETAN DAVAE (MD)
NPI
1700838620
Phone
(952) 595-1301
Address
11995 SINGLETREE LN STE 500
Enumeration Date
17 May 2006
Last Update Date
15 January 2025

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
Secondary Phone
4697571042
Graduation Year
1994 (32 years ago)
PAC ID
7012996366
Group Practice PAC ID
4385170810
Professional Enrollment ID
I20220706003838
Address ID
OH440849444RO3031XLNXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience82
Completeness75
Years active:20State licenses:3Digital endpointsOther names

4,793 DIAGNOSTIC RADIOLOGY in CA

Provider Addresses for KETAN DAVAE (MD)

  • 11995 SINGLETREE LN STE 500

    EDEN PRAIRIE, MN 553445349

    Phone: (952) 595-1301

    Fax: (612) 294-4903

    Type: Mailing

  • 39000 Bob Hope Dr

    Rancho Mirage, CA 922703221

    Phone: (760) 340-3911

    Type: Location

  • 3600 MINNESOTA DR STE 500

    EDINA, MN 554357979

    Phone: (952) 595-1301

    Fax: (612) 294-4903

    Type: Mailing

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: 2022-07-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 6 Medicare enrollment records; no due dates published yet.

Enrollment records

6

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
I20070709000439IDiagnostic RadiologyMITBD
I20090610000266IDiagnostic RadiologyTXTBD
I20111208000463IDiagnostic RadiologyMATBD
I20190408000534IDiagnostic RadiologyAKTBD
I20220706003838IDiagnostic RadiologyOHTBD
I20220729002249IDiagnostic RadiologyWATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
70450Ct scan head or brain without contrast169169$0
74177Ct scan of abdomen and pelvis with contrast133133$0
74176Ct scan of abdomen and pelvis without contrast9393$0
71045X-ray of chest, 1 view8786$0
72125Ct scan of upper spine without contrast8181$0
View full utilization report →

Insurance plans in this area (ZIP 55344)

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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: 4385170810View full group profile
NameSpecialtyState
Diagnostic RadiologyOH
Diagnostic RadiologyTN
Diagnostic RadiologyPA
Diagnostic RadiologyMN
Diagnostic RadiologyKY
Diagnostic RadiologyFL
Diagnostic RadiologyPA
Diagnostic RadiologyIL
Diagnostic RadiologyCA
Diagnostic Radiology, Nuclear MedicinePA

Reviews

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Frequently asked questions

Does KETAN DAVAE (MD) have a public NPI I can cite?
Public records show KETAN DAVAE (MD) under NPI 1700838620.
Is KETAN DAVAE (MD)'s NPI status active today?
Active status means KETAN DAVAE (MD)'s NPI record is not deactivated in the public file.
Which specialty label fits KETAN DAVAE (MD)?
NPPES ties KETAN DAVAE (MD) to Diagnostic Radiology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit KETAN DAVAE (MD) in Eden Prairie, Minnesota?
For routing, start with Eden Prairie, Minnesota for KETAN DAVAE (MD), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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