KEITH M HEATON (M.D.) – Surgery Physician, NPI 1962485508
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
730 GENERAL SURGERY in MN
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Provider Addresses for KEITH M HEATON (M.D.)
3800, Park Nicollet Boulevard, Elmwood, Saint Louis Park, Hennepin County, Minnesota, 55416, United States
CREDENTIALING
ST LOUIS PARK, MN 554162527
Phone:
Type: Mailing
Park Nicollet Clinic, 3900, Park Nicollet Boulevard, Wolfe Park, Saint Louis Park, Hennepin County, Minnesota, 55416, United States
ST LOUIS PARK, MN 554162503
Phone: (952) 993-3180
Type: Location
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 554162527
Phone: (952) 993-3700
Fax: (952) 993-1750
Type: Location
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN 554254516
Phone:
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: 2010-02-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100203000462 | I | General Surgery | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 36 | 36 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 16 | 16 | $0 |
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 15 | 15 | $0 |
| 19301 | Partial removal of breast | 13 | 13 | $0 |
| 38792 | Injection of radioactive material for x-ray identification of lymph node | 12 | 12 | $0 |
Insurance plans in this area (ZIP 55416)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | MN | 38900 | Lymph node imaging during surgery | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Family Practice | MN | |
| - | MN | |
| Pulmonary Disease, Critical Care (Intensivists), Internal Medicine | MN | |
| Cardiac Electrophysiology | MN | |
| Family Practice | MN | |
| Physician Assistant | MN | |
| Physical Therapist In Private Practice | MN | |
| Physician Assistant | MN | |
| D E R M A T O L O G Y | MN |
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