Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Renal Disease Network of the Upper Midwest, Inc. - Network 11 (Midwest Kidney Network) before sending sensitive documents. FaxFlow is not affiliated with this organization.

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Renal Disease Network of the Upper Midwest, Inc. - Network 11 (Midwest Kidney Network) fax number

(651) 644-9853

Network Administration / ESRD Network 11

Used for: Submitting ESRD-related data and medical documentation (e.g., CMS 2728 submissions) and receiving related confirmations/communications from Network 11.

Fax destination details

Department
Network Administration / ESRD Network 11
Purpose
Submitting ESRD-related data and medical documentation (e.g., CMS 2728 submissions) and receiving related confirmations/communications from Network 11.
Form
CMS 2728 Form — ESRD Medical Evidence Report Medicare Entitlement and/or Patient Registration (CMS-2728)
Address
1360 Energy Park Drive, Suite 320, St. Paul, MN 55108
Voice phone
(651) 644-9877

Before you send

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  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Special Instructions: Contact your local Social Security office for copies of this form. The CMS 2728 form documents ESRD medical evidence and patient entitlement/registration.

Review official form instructions

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