KENNETH JOHN GUIDERA M.D.
NPI 1922150697
Orthopaedic Surgery - Pediatric Orthopaedic Surgery in Minneapolis, MN

Q: What is Kenneth Guidera's NPI number?

The NPI number for Kenneth Guidera is 1922150697. It was assigned to this individual provider in the NPPES registry on January 16, 2007.

Q: What is Kenneth Guidera's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Pediatric Orthopaedic Surgery, with taxonomy code 207XP3100X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Guidera was last updated on April 4, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since January 16, 2007PECOS Enrolled

2025 E RIVER PKWY, MINNEAPOLIS, MN 55414(612) 596-6187(612) 339-7634 Get Directions Write a Review

NPPES record last updated: April 4, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kenneth John Guidera M.d. NPPES

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

KENNETH JOHN GUIDERA M.D. (NPI 1922150697) is an individual pediatric orthopaedic surgery provider in Minneapolis, Minnesota, licensed in Minnesota (47329) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1922150697

Entity TypeIndividualMale

Primary Taxonomy207XP3100X

Provider Legal NameKENNETH JOHN GUIDERACredential: M.D.

Location Address2025 E RIVER PKWYMinneapolis, MN 55414-3604

Mailing AddressP.o. Box 209036, Shriners Hospitals For Children Twin CitiesDallas, TX 75320-9036 · (813) 281-8478 · Fax (813) 281-8113

Phone(612) 596-6187

Fax(612) 339-7634

Sole ProprietorNo

Enumeration DateJanuary 16, 2007

Last NPPES UpdateApril 4, 2011

✔ NPI 1922150697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Pediatric Orthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207XP3100X

License✔ Licensed in MN · 47329

Definition

An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones.

2025 E RIVER PKWY, Minneapolis, MN 55414

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Other Identifiers 3

Medicaid1922150697MN

Medicare UPIND51330MN

Medicaid158417100MN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth John Guidera M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 18

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

FAIRVIEW EXPRESS CARE

Clinic/Center