REID KENNETH MIMMACK MD
NPI 1861070948
Anesthesiology in Minneapolis, MN
About Reid Kenneth Mimmack Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REID KENNETH MIMMACK MD (NPI 1861070948) is an individual anesthesiology provider in Minneapolis, Minnesota, licensed in Minnesota (79473) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS, is affiliated with Park Nicollet Methodist Hospital, and is a graduate of University Of Minnesota Medical School (2021).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Reid Kenneth Mimmack Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Reid Mimmack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Plymouth, MN 55447
- Reassigned Medicare billing, Minnesota enrollment
- 1,033 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Park Nicollet Methodist Hospital
Acute Care Hospitals · Saint Louis Park, MNOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MINNEAPOLIS, MN 55415
MINNEAPOLIS, MN 55415
MINNEAPOLIS, MN 55415
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 Reid Mimmack's NPI number?
The NPI number for Reid Mimmack is 1861070948. It was assigned to this individual provider in the NPPES registry on March 31, 2021.
Where is Reid Mimmack located?
Reid Mimmack practices at 701 Park Ave, Minneapolis, MN 55415. The listed phone number is (612) 873-3000.
What is Reid Mimmack's specialty?
The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.
Is Reid Mimmack enrolled in Medicare?
Yes. Reid Mimmack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Reid Mimmack's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Reid Mimmack reassigns Medicare benefits to Metropolitan Anesthesia Network, LLP (Plymouth, MN). The 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 Reid Mimmack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Reid Mimmack affiliated with any hospitals?
According to CMS data, Reid Mimmack is affiliated with Park Nicollet Methodist Hospital.
When was this NPI record last updated?
The NPPES record for Reid Mimmack was last updated on July 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.
# Reid Kenneth Mimmack, MD · NPI 1861070948
Anesthesiology physician in Minneapolis, Minnesota. Individual provider, active in the CMS NPPES registry since March 31, 2021.
## Identity
- **NPI:** 1861070948 (Entity type: Individual)
- **Enumerated:** March 31, 2021
- **Primary specialty:** Anesthesiology · taxonomy 207L00000X
- **State license:** 79473 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 701 PARK AVE, Minneapolis, MN 55415-1623
- **Phone:** (612) 873-3000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Metropolitan Anesthesia Network, LLP (NPI 1558314427, Plymouth, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Minnesota Medical School, class of 2021
## Record status
- **NPPES last updated:** July 3, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1861070948) · Data from the CMS NPPES public registry.