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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KEITH BRYAN CORDNER JR. MD
NPI 1558059337
Internal Medicine in Minneapolis, MN

Active since April 28, 2023PECOS Enrolled
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 273-8383 Get Directions Write a Review

NPPES record last updated: October 14, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 14, 2026, Apr 29, 2024 (2 updates tracked since 2024).

About Keith Bryan Cordner Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEITH BRYAN CORDNER JR. MD (NPI 1558059337) is an individual internal medicine provider in Minneapolis, Minnesota, licensed in Michigan (4301517912) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS, maintains 8 additional practice locations, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1558059337
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameKEITH BRYAN CORDNER JR.Credential: MD
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450
Mailing Address4000 Wellness DrMidland, MI 48670-2000 · (844) 832-1956 · Fax (989) 633-5241
Phone(612) 273-8383
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateApril 28, 2023
Last NPPES UpdateOctober 14, 20262 updates tracked since enumeration
NPPES CertifiedOctober 14, 2026
✔ NPI 1558059337 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 4301517912
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2450 RIVERSIDE AVE, Minneapolis, MN 55454
Open in Google Maps ↗

Secondary Practice Locations 8

Location 12463 S M 30West Branch, MI 48661-9312 · Phone (989) 839-1644 · Fax (989) 839-3029
Location 2300 E Warwick DrAlma, MI 48801-1014 · Phone (989) 839-1644 · Fax (989) 839-3029
Location 3515 Quarter StGladwin, MI 48624-1959 · Phone (989) 839-1644 · Fax (989) 839-3029
Location 4500 Osborn BlvdSault Sainte Marie, MI 49783-1822 · Phone (906) 635-4460 · Fax (906) 635-4467
Location 5800 S Washington AveSaginaw, MI 48601-2551 · Phone (989) 839-1644 · Fax (989) 839-3029
Location 6703 N McEwan StClare, MI 48617-1440 · Phone (989) 839-1644 · Fax (989) 839-3029
Location 74000 Wellness DrMidland, MI 48670-2000 · Phone (989) 839-1644
Location 8200 Hemlock RdTawas City, MI 48763-2000 · Phone (989) 839-1644

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Keith Bryan Cordner Jr. Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365801958
PECOS Enrollment IDI20260605001866
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Keith Cordner reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mymichigan Medical Center Sault
434 mi
Family Medicine
16523 S WATER TOWER DR
Kincheloe, MI 49788
  • Reassigned Medicare billing, Michigan enrollment
  • 185 clinicians in this Medicare group
NPI 1851434419 (906) 495-1344
Mymichigan Medical Group
454 mi
Obstetrics & Gynecology
4401 N CAMPUS RDG
Midland, MI 48640
  • Reassigned Medicare billing, Michigan enrollment
  • 197 clinicians in this Medicare group
NPI 1477503852 (989) 837-9400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55454 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE IRENE GRAY
Rehabilitation Practitioner
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
DR. KATHLEEN F SADAK MD
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-6402
DR. ADMATHA MUTHYALA WINFRED MD
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
KELLY SCHELLER WILLIAMS
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3216
MRS. MARY SUSAN CLIPP CPNP-AC
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 365-3100
DANIEL TESFAYE KEBED MD
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MS. CHELSEA ANJELICA MIELKE PA-C
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MRS. JESSICA LYNN MCADAM
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-8383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keith Cordner's NPI number?

The NPI number for Keith Cordner is 1558059337. It was assigned to this individual provider in the NPPES registry on April 28, 2023.

Where is Keith Cordner located?

Keith Cordner practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 273-8383.

What is Keith Cordner's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Keith Cordner enrolled in Medicare?

Yes. Keith Cordner is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Keith Cordner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Keith Cordner reassigns Medicare benefits to 2 organizations: Mymichigan Medical Center Sault (Kincheloe, MI) and Mymichigan Medical Group (Midland, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Keith Cordner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Keith Cordner was last updated on October 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.