DR. DOMINIC PAUL DECKER (NPI# 1043667496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043667496 |
| Entity Type | Individual |
| Full Name | DR. DOMINIC PAUL DECKER |
| Credential | M.D. |
| Practice Address |
1221 W Lake St Ste 201 Minneapolis MN 55408 |
| Mailing Address |
2925 Chicago Ave Minneapolis MN 55407-1321 |
| Practice Telephone | 6128241772 |
| Mailing Telephone | 6122625000 |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2020-11-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 65200 | MN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 593 Eddy St, Providence, RI 029034923 | 4014444741 | 4014444445 |
| Street Address |
1221 W LAKE ST STE 201 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952302085 | Veeti Tandon | Internal Medicine | 1221 W Lake St Ste 201, Minneapolis, MN 55408-3565 | 2005-08-10 |
| 1932517844 | William Larson | Pharmacist | 1221 W Lake St Ste 201, Minneapolis, MN 55408-3565 | 2014-07-24 |
| 1821364001 | Collin Davidson | Psychologist | 1221 W Lake St Ste 201, Minneapolis, MN 55408-3565 | 2012-04-01 |
| 1669659330 | Alison Marie Bormann | Internal Medicine | 1221 W Lake St Ste 201, Minneapolis, MN 55408-3565 | 2008-01-24 |
| 1629278726 | Alina Aloma | Psychologist | 1221 W Lake St Ste 201, Minneapolis, MN 55408 | 2007-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548870512 | Community Solutions Services Inc | Counselor | 3043 2nd Ave South, Suite 101, Minneapolis, MN 55408 | 2020-08-05 |
| 1356962740 | Mohammad Mushtaq Khandwala | Student in an Organized Health Care Education/Training Program | 2810 Nicollet Avenue South, Minneapolis, MN 55408 | 2020-04-27 |
| 1861012700 | Open Arms Group Home LLC | Nursing Care | 1 W Lake St Suite 165 Unit 7, Minneapolis, MN 55408 | 2020-04-21 |
| 1538710413 | Yuejuan Bian | Acupuncturist | 2743 Lyndale Ave S, Suite 2, Minneapolis, MN 55408 | 2019-09-23 |
| 1710536081 | Blu Care Inc | Clinic/Center | 2910 Pillsbury Ave S Ste 338, Minneapolis, MN 55408 | 2019-09-09 |
| 1417510165 | Kau Macador Queeglay | Counselor | 621 West Lake Street Suite 350 Lynlake Building, Minneapolis, MN 55408 | 2019-04-18 |
| 1346735875 | Nicole S Ehrenberg | Social Worker | 324 E 35th Street, Minneapolis, MN 55408 | 2018-06-27 |
| 1639681612 | American Family Transportation Inc | Non-emergency Medical Transport (VAN) | 2910 Pillsbury Ave So Suite 434, Minneapolis, MN 55408 | 2017-10-30 |
| 1285181743 | Multilingual Word Inc | Interpreter | 1431 W 32nd St, Minneapolis, MN 55408 | 2016-09-01 |
| 1376906388 | Sama Healthcare | Family Medicine | 2639 Nicollet Ave., Suite 130, Minneapolis, MN 55408 | 2016-03-29 |
| Find all providers in zip 55408 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861032054 | David Gregg | Internal Medicine | 5305 Humboldt Ave S, Minneapolis, MN 55419 | 2020-01-15 |
| 1316454077 | Independent Medical Clinic Pa | Internal Medicine | 2639 Nicollet Ave Ste 120, Minneapolis, MN 55408-1629 | 2018-01-03 |
| 1669905618 | Joseph Douglas Steffens | Internal Medicine | 701 Park Avenue, Internal Medicine Residency Program, Hennepin County Medical Center, Minneapolis, MN 55415 | 2017-04-06 |
| 1841650306 | Megan Mcgovern | Internal Medicine | 701 Park Ave # O1.340, Minneapolis, MN 55415-1623 | 2016-02-26 |
| 1700266079 | Jacob Wagner | Internal Medicine | D638 Mayo Building, 420 Delaware St Se, Minneapolis, MN 55455 | 2015-06-02 |
| 1659750503 | Melissa Ann Plesac | Internal Medicine | 500 Harvard St Se # 741, Minneapolis, MN 55455 | 2015-05-26 |
| 1033503040 | Elizabeth Stanton Teter Aby | Internal Medicine | 406 Harvard St Se # Mmc36, Minneapolis, MN 55455-0362 | 2015-03-27 |
| 1780002592 | Annie M Jacobsen | Internal Medicine | 701 Park Avenue South--medicine, Hennepin County Medical Center, Minneapolis, MN 55415-1829 | 2014-03-31 |
| 1386066173 | Michael Usher | Internal Medicine | 420 Delaware Street, Se, Mmc 741, Division of General Internal Medicine, Minneapolis, MN 55455 | 2014-01-13 |
| 1356684609 | Anteneh Girma Zewde | Internal Medicine | 87 Orlin Ave Se, Minneapolis, MN 55414-3560 | 2013-04-04 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55408 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.