NEW KINGDOM PEDIATRICS LLC
NPI 1760816045
Clinic/Center in Eden Prairie, MN
About New Kingdom Pediatrics Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NEW KINGDOM PEDIATRICS LLC (NPI 1760816045) is a healthcare organization registered as a clinic/center in Eden Prairie, Minnesota and active in the NPI registry since August 2013. The organization lists Robert Zajac, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
New Kingdom Pediatrics Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
30Medicare enrollment records show 30 clinicians reassign Medicare billing to New Kingdom Pediatrics LLC, which bills Medicare for the services they deliver. Of these, 14 practice at this address and 15 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 4
Nearest to this location (20)
See all 30Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 New Kingdom Pediatrics LLC's NPI number?
The NPI number for New Kingdom Pediatrics LLC is 1760816045. It was assigned to this organization in the NPPES registry on August 22, 2013.
Where is New Kingdom Pediatrics LLC located?
New Kingdom Pediatrics LLC is located at 6452 City West Pkwy, Eden Prairie, MN 55344. The listed phone number is (952) 999-0333.
What is New Kingdom Pediatrics LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is New Kingdom Pediatrics LLC enrolled in Medicare?
Yes. New Kingdom Pediatrics LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through New Kingdom Pediatrics LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 30 clinicians in 4 Medicare specialties reassign their Medicare billing to New Kingdom Pediatrics LLC. A 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 the clinician's services. The largest specialties are Nurse Practitioner (25), Pediatric Medicine (3) and Internal Medicine (1). Of these, 14 practice at this address and 15 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for New Kingdom Pediatrics LLC was last updated on August 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.
# New Kingdom Pediatrics Llc · NPI 1760816045
Clinic/Center organization in Eden Prairie, Minnesota. Organization record, active in the CMS NPPES registry since August 22, 2013.
## Identity
- **NPI:** 1760816045 (Entity type: Organization)
- **Enumerated:** August 22, 2013
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Organization subpart:** No
- **Authorized official:** Robert Zajac, CEO
## Practice location
- **Address:** 6452 CITY WEST PKWY, Eden Prairie, MN 55344-3245
- **Phone:** (952) 999-0333
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 30 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (25), Pediatric Medicine (3), Internal Medicine (1); 14 practice at this address and 15 within 10 miles; [full list](https://npiprofile.com/npi/1760816045/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2013
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Source: [NPI Profile](https://npiprofile.com/npi/1760816045) · Data from the CMS NPPES public registry.