MINNESOTA VASCULAR CLINIC, PLLC (NPI# 1174554653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174554653 |
| Entity Type | Organization |
| Organization Name | MINNESOTA VASCULAR CLINIC, PLLC |
| Practice Address |
6405 France Ave S Suite W440 Edina MN 55435-2163 |
| Mailing Address |
4570 W 77th St Suite 235 Edina MN 55435-5008 |
| Practice Telephone | 9529277004 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ANDREW CRAGG (SHAREHOLDER) |
| Authorized Official Telephone | 9528379700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2086S0129X |
Surgery Specialization: Vascular Surgery |
1655 | MN | Allopathic & Osteopathic Physicians |
| X | 261QR0200X |
Clinic/Center Specialization: Radiology |
1655 | MN | Ambulatory Health Care Facilities |
| Street Address |
6405 FRANCE AVE S SUITE W440 |
| City | EDINA |
| State | MN |
| Zip Code | 55435-2163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710972864 | Demosthenes N Iskos | Internal Medicine | 6405 France Ave S, Suite W200, Edina, MN 55435-2163 | 2005-09-14 |
| 1790145738 | Aybike Bakan-fischer | Physician Assistant | 6405 France Ave S, Edina, MN 55435-2163 | 2016-03-03 |
| 1225496128 | Stephanie Rose Norgaard-erickson | Nurse Practitioner | 6405 France Ave S, Suite W200, Edina, MN 55435-2163 | 2016-02-05 |
| 1851717136 | Eric Richard Nelson Md | Ophthalmology | 6405 France Ave S, Suite W460, Edina, MN 55435-2163 | 2014-03-11 |
| 1538599790 | Fairview Health Services | Clinic/Center | 6405 France Ave S, Suite 480, Edina, MN 55435 | 2013-11-25 |
| 1538504014 | Erin Jean Frendin | Physician Assistant | 6405 France Ave S, Ste W200, Edina, MN 55435-2163 | 2013-05-09 |
| 1689937963 | Brittany N Smith | Physician Assistant | 6405 France Ave S, Edina, MN 55435 | 2012-06-21 |
| 1336409978 | Katherine Eileen Hawkins | Surgery | 6405 France Ave S, Edina, MN 55435-2163 | 2012-05-16 |
| 1265721906 | Joy A Hasseler | Obstetrics & Gynecology | 6405 France Ave S, Ste W400, Edina, MN 55435-2163 | 2011-04-04 |
| 1710133343 | Fairview Express Care | Internal Medicine | 6405 France Ave S, Ste 200, Edina, MN 55435-2163 | 2008-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215947288 | Kamran Karimi | Surgery | 6405 France Ave S Ste W320, Edina, MN 55435-2188 | 2006-08-09 |
| 1972762631 | Reese Surgical Group Pllc | Surgery | 6525 France Ave S, Suite 305, Edina, MN 55435-2148 | 2008-06-06 |
| 1134152085 | Robert Joseph Reese | Surgery | 6525 France Ave S, Suite, Edina, MN 55435-2148 | 2006-07-07 |
| 1730166992 | Matthew Melin | Surgery | 6405 France Ave S Ste W440, Edina, MN 55435 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265721757 | Yauhen Alexander Tarbunou | Surgery | 1200 6th Ave. N., St. Cloud, MN 56303-2735 | 2011-04-05 |
| 1083894836 | Vascular Surgery Associates Pa | Surgery | 3887 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2518 | 2007-11-09 |
| 1649217159 | Roger S Hogue | Surgery | 7365 Kirkwood Ct N, Ste 120, Maple Grove, MN 55369-4721 | 2006-06-01 |
| 1720025455 | Rumi Faizer | Surgery | 314 Variety Club Research Center, 401 East River Parkway Division of Vascular Surgery, Minneapolis, MN 55455 | 2006-06-01 |
| 1518938067 | David Reed Knighton | Surgery | 2460 Highway 100 S, St Louis Park, MN 55416-1704 | 2006-01-31 |
| 1679100937 | Jesse Chait | Surgery | 200 1st St Sw, Rochester, MN 55905-0002 | 2020-03-26 |
| 1699235689 | Armin Farazdaghi | Surgery | 200 First Street Sw, Rochester, MN 55905-0001 | 2019-03-25 |
| 1093210262 | Nolan C Cirillo-penn | Surgery | 200 1st St Sw, Rochester, MN 55905 | 2018-03-28 |
| 1760915862 | Indrani Sen | Surgery | 200 1st St Sw, Mayo Clinic, Rochester, Rochester, MN 55905-0001 | 2017-04-05 |
| 1306380571 | St. Luke's Hospital of Duluth | Surgery | 1000 E 1st St, Ste. 203, Duluth, MN 55805-2297 | 2016-12-07 |
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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.