MINNESOTA ONCOLOGY HEMATOLOGY, PA (NPI# 1356585442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356585442 |
Entity Type | Organization |
Organization Name | MINNESOTA ONCOLOGY HEMATOLOGY, PA |
Practice Address |
480 Osborne Rd Ne Suite 220 Fridley MN 55432 |
Practice Telephone | 7637861620 |
Practice Fax Number | 7637803099 |
Mailing Telephone | 7637861620 |
Mailing Fax Number | 7637803099 |
Enumeration Date | 2009-04-21 |
Last Update Date | 2010-10-07 |
Authorized Official Name | THOMAS P FLYNN (PRESIDENT) |
Authorized Official Telephone | 6128638585 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
1076 | MN | Allopathic & Osteopathic Physicians |
N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
1076 | MN | Allopathic & Osteopathic Physicians |
N | 363L00000X | Nurse Practitioner | 1076 | MN | Physician Assistants & Advanced Practice Nursing Providers |
Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
1076 | MN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | MEDICARE ID | C01828 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770123697 | Minnesota Oncology Hematology, Pa | Radiology | 1580 Beam Ave, Saint Paul, MN 55109-1127 | 2020-01-08 |
1598305427 | Minnesota Oncology Hematology, Pa | Radiology | 345 Sherman St Ste 100, Saint Paul, MN 55102-2401 | 2020-01-08 |
1114430089 | Minnesota Oncology Hematology, Pa | Internal Medicine | 6025 Lake Rd Ste 200, Woodbury, MN 55125-1710 | 2017-11-14 |
1881130417 | Minnesota Oncology Hematology, Pa | Internal Medicine | 601 W Chandler St, Arlington, MN 55307-2127 | 2017-01-06 |
1619111705 | Minnesota Oncology Hematology, Pa | Dietitian, Registered | 11850 Blackfoot Nw, Suite 100, Coon Rapids, MN 55433-2569 | 2009-04-21 |
1447409834 | Minnesota Oncology Hematology, Pa | Obstetrics & Gynecology | 3960 Coon Rapids Blvd Nw, Suite 101, Coon Rapids, MN 55433-2569 | 2008-09-10 |
1851569909 | Minnesota Oncology Hematology, Pa | Physician Assistant | 6363 France Ave S, Suite 200, Edina, MN 55435-2129 | 2008-02-12 |
1609911205 | Minnesota Oncology Hematology, Pa | Dietitian, Registered | 345 Sherman St, Suite 100, Saint Paul, MN 55102-2401 | 2007-02-21 |
1447394424 | Minnesota Oncology Hematology, Pa | Dietitian, Registered | 560 S Maple St, Suite 100, Waconia, MN 55387-1760 | 2007-02-16 |
1467595868 | Minnesota Oncology Hematology, Pa | Nurse Practitioner | 675 E Nicollet Blvd Ste 100, Burnsville, MN 55337-6749 | 2007-02-15 |
Street Address |
480 OSBORNE RD NE SUITE 220 |
City | FRIDLEY |
State | MN |
Zip Code | 55432 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275528671 | Multicare Associates of The Twin Cities,pa | Obstetrics & Gynecology | 480 Osborne Rd Ne, Suite 100, Fridley, MN 55432-2773 | 2005-09-13 |
1063923233 | Christina Louise Ann Her | Occupational Therapist | 480 Osborne Rd Ne, Fridley, MN 55432-2773 | 2017-10-16 |
1972039527 | North Memorial Health Care | Clinic/Center | 480 Osborne Rd Ne, #100, Fridley, MN 55432-2773 | 2017-05-02 |
1619401270 | Betlehem Semahge | Family Medicine | 480 Osborne Rd Ne, Fridley, MN 55432-2773 | 2017-04-20 |
1588035612 | Yelena Babashova | Physician Assistant | 480 Osborne Rd Ne, Fridley, MN 55432-2773 | 2015-10-15 |
1285014811 | Nura Pa | Durable Medical Equipment & Medical Supplies | 480 Osborne Rd Ne, Suite 260, Fridley, MN 55432-2773 | 2015-06-09 |
1194105841 | Pain Centers of Minnesota - Fridley, LLC | Clinic/Center | 480 Osborne Rd Ne, Suite 260, Fridley, MN 55432-2773 | 2015-06-08 |
1003215542 | Alison Gardner | Physician Assistant | 480 Osborne Rd Ne, Fridley, MN 55432-2773 | 2014-08-20 |
1629408687 | Danielle Elizabeth Nelson | Physician Assistant | 480 Osborne Rd Ne, Fridley, MN 55432-2773 | 2013-11-12 |
1043646029 | Patrick David Carlson | Physical Therapist | 480 Osborne Rd Ne, #280, Fridley, MN 55432-2773 | 2013-09-23 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
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Taxonomy Code | 207RH0003X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Hematology & Oncology |
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437241312 | Stephen C Mann | Internal Medicine | 480 Osborne Rd Ne, Suite 220, Fridley, MN 55432-2773 | 2006-09-29 |
1376635250 | Dorothy L Uhlman | Internal Medicine | 500 Osborne Road, Suite 215, Fridley, MN 55432 | 2006-09-29 |
1427068618 | Thomas T Amatruda IIi | Internal Medicine | 480 Osborne Rd Ne, Suite 220, Fridley, MN 55432-2866 | 2006-08-09 |
1346254430 | Uzma Ali | Internal Medicine | 480 Osborne Rd Ne, Suite 220, Fridley, MN 55432-2773 | 2006-07-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780041301 | Nicole Jacobi | Internal Medicine | 701 Park Avenue Mail Code O1.340, Minneapolis, MN 55415-1623 | 2016-01-27 |
1366691636 | Laxmidas Anant Sawkar | Internal Medicine | 11376 Sandcastle Dr, Woodbury, MN 55129-8562 | 2008-09-11 |
1669628517 | Howard Clark Hoagland | Internal Medicine | 1705 Folwell Dr Sw, Rochester, MN 55902-0987 | 2008-08-12 |
1366626343 | Hilary Ikenna Ufearo | Internal Medicine | 1900 Centracare Circle, #1600, Centracare Clinic Health Plaza Specialties/oncology, St Cloud, MN 56303-5000 | 2007-12-26 |
1598851198 | Douglas Yee | Internal Medicine | Masonic Cancer Center, First Floor, Suite M100, 424 Harvard Street Se, Minneapolis, MN 55455 | 2006-10-04 |
1073605952 | John Manion | Internal Medicine | 3435 West Broadway, Suite 1065, Robbinsdale, MN 55422 | 2006-09-29 |
1194817072 | Robert D Winston | Internal Medicine | 3960 Coon Rapids Blvd, Suite 311, Coon Rapids, MN 55433 | 2006-09-29 |
1023111531 | Ayse Malcolm | Internal Medicine | 1455 St. Francis Avenue, St. Francis Regional Medical Center, Shakopee, MN 55379-3380 | 2006-09-07 |
1821008996 | Joseph Michael Cardamone Jr. | Internal Medicine | 11850 Blackfoot Ne, Suite 100, Coon Rapids, MN 55433-2598 | 2006-08-09 |
1134135106 | Kendra L. Kubiak | Internal Medicine | 3931 Louisiana Avenue, St Louis Park, MN 55426 | 2006-07-31 |
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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.