NORTHPORT MEDICAL CENTER LTD (NPI# 1174684336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174684336 |
| Entity Type | Organization |
| Organization Name | NORTHPORT MEDICAL CENTER LTD |
| Practice Address |
5415 Brooklyn Blvd Brooklyn Center MN 55429-3359 |
| Practice Telephone | 7635338666 |
| Practice Fax Number | 7635338711 |
| Mailing Telephone | 7635338666 |
| Mailing Fax Number | 7635338711 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2008-02-15 |
| Authorized Official Name | DUANE L ORN (OWNER) |
| Authorized Official Telephone | 7635338666 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 749 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
5415 BROOKLYN BLVD |
| City | BROOKLYN CENTER |
| State | MN |
| Zip Code | 55429-3359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215255955 | Tria Lor | Family Medicine | 5415 Brooklyn Blvd, Brooklyn Center, MN 55429-3359 | 2010-05-05 |
| 1902960925 | Duane L Orn | Family Medicine | 5415 Brooklyn Blvd, Brooklyn Center, MN 55429 | 2006-12-21 |
| 1891856050 | Elizabeth A Rahberg | Physician Assistant | 5415 Brooklyn Blvd, Brooklyn Center, MN 55429-3359 | 2006-12-12 |
| 1932260189 | John C Muesing | Family Medicine | 5415 Brooklyn Blvd, Brooklyn Center, MN 55429 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245852979 | Comfort Home Care | Home Health | 5950 Beard Ave N, Brooklyn Center, MN 55429 | 2020-05-15 |
| 1205300969 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4835-4901 West Boradway Avenue, Crystal, MN 55429 | 2019-01-16 |
| 1780156208 | Crescent Cove | Pediatrics | 4201 58th Avd N., Brooklyn Center, MN 55429 | 2018-12-21 |
| 1184106254 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4835-4901 W. Broadway Ave, Crystal, MN 55429 | 2018-09-05 |
| 1952889073 | Kelly Mcgregory Pediatrics LLC | Pediatrics | 6000 Bass Lake Rd Ste 102, Crystal, MN 55429 | 2018-07-31 |
| 1023510526 | Family Trust Home Health, LLC | Home Health | 5901 Brooklyn Blvd Ste 201, Brooklyn Center, MN 55429 | 2018-03-01 |
| 1962910588 | Yer Yang | Massage Therapist | 5531 Orchard Ave N, Crystal, MN 55429 | 2018-01-17 |
| 1790203347 | Akeya Bolden | Counselor | 3212 64th Ave N, Brooklyn Center, MN 55429 | 2017-09-05 |
| 1386169316 | Sadia Pauletta Kruah | Transportation Broker | 6756 Grimes Pl North, Brooklyn Center, MN 55429 | 2017-08-10 |
| 1982134904 | Chad Geyen | Marriage & Family Therapist | 3300 County Rd. 10, Brooklyn Center, MN 55429 | 2017-06-13 |
| Find all providers in zip 55429 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174642540 | Saima Mahmood Ahmer | Family Medicine | 6845 Lee Ave N - Ms 31400a, Healthpartners Brooklyn Center Clinic, Brooklyn Center, MN 55429-1717 | 2007-03-28 |
| 1184705162 | Verna Hillstrom | Family Medicine | 6601 Shingle Creek Pkwy, Ste 400, Brooklyn Center, MN 55430-1741 | 2006-10-18 |
| 1033193156 | Mark Depaolis | Family Medicine | 6000 Earle Brown Dr, Brooklyn Center, MN 55430-2506 | 2005-12-01 |
| 1104351584 | Katherine Swanson | Family Medicine | 6000 Earle Brown Dr, Brooklyn Center, MN 55430-2506 | 2017-04-24 |
| 1780061051 | Jennifer Barnes Manning | Family Medicine | 6000 Earle Brown Dr, Brooklyn Center, MN 55430-2506 | 2015-05-06 |
| 1609281757 | Alexandra Oleinik | Family Medicine | 6000 Earle Brown Dr, Brooklyn Center, MN 55430-2506 | 2014-06-27 |
| 1396156667 | Camille Delisi | Family Medicine | 6000 Earle Brown Dr, Brooklyn Center, MN 55430-2506 | 2014-05-08 |
| 1215255955 | Tria Lor | Family Medicine | 5415 Brooklyn Blvd, Brooklyn Center, MN 55429-3359 | 2010-05-05 |
| 1730356098 | Erik Stanley Haugland | Family Medicine | 5615 Xerxes Ave N, Suite D, Brooklyn Center, MN 55430-2819 | 2008-05-14 |
| 1508032780 | Subhashini Mahipathi | Family Medicine | 6845 Lee Ave N - Mail Stop 31400a, Healthpartners Brooklyn Center Clinic, Brooklyn Center, MN 55429-1717 | 2008-05-07 |
| Find all providers in BROOKLYN CENTER | ||||
| City | BROOKLYN CENTER |
| Zip Code | 55429 |
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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.