DR. ANASTAS C PROVATAS (NPI# 1497740054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497740054 |
| Entity Type | Individual |
| Full Name | DR. ANASTAS C PROVATAS |
| Credential | MD |
| Practice Address |
3605 Mayfair Ave Hibbing MN 55746-2935 |
| Practice Telephone | 2182623441 |
| Practice Fax Number | 2183626908 |
| Mailing Telephone | 2182623441 |
| Mailing Fax Number | 2183626908 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2011-04-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
105335 | MN | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
9500693 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
3605 MAYFAIR AVE |
| City | HIBBING |
| State | MN |
| Zip Code | 55746-2935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073094850 | Caitlin Leigh Lockard | Physician Assistant | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2018-08-28 |
| 1134572092 | Susan Hoyum | Family Medicine | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2016-07-15 |
| 1417309873 | Jeanne Marie Antonich | Nurse Practitioner | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2016-07-11 |
| 1962860965 | Steven Eldor Breitbarth | Marriage & Family Therapist | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2016-02-04 |
| 1205222833 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2015-04-10 |
| 1992059711 | James C Hooker | Counselor | 3605 Mayfair Ave, Hibbing, MN 55746-2341 | 2012-10-31 |
| 1043569148 | Janean Marie Mccue | Nurse Practitioner | 3605 Mayfair Ave, Fairview Mesaba Clinic, Hibbing, MN 55746 | 2012-09-05 |
| 1003170424 | Dustin Dean Lucarelli | Surgery | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2012-06-29 |
| 1952669525 | Kasey Lynn Kapella | Family Medicine | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2012-05-02 |
| 1841557022 | Joseph Skaja | Surgery | 3605 Mayfair Ave, Fairview Mesaba Clinic, Hibbing, MN 55746 | 2012-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922594753 | Brekke Lee Johnsrud | Dentist | 2020 1st Avenue, Hibbing, MN 55746 | 2018-07-04 |
| 1558751495 | Weston Mark Schmidt | Dental Therapist | 411 East Howard St., Jacobson Family Dentistry PC, Hibbing, MN 55746 | 2015-01-30 |
| 1467870485 | Angela Wivoda | Contractor | 302 East Howard Street, Suite 310, Hibbing, MN 55746 | 2014-04-07 |
| 1871897512 | Nicholas G Ongaro | Chiropractor | 4104 9th Ave W, Hibbing, MN 55746 | 2011-01-10 |
| 1689800153 | Kathleen M Delgreco | Social Worker | 3203 W. 3rd Ave, Hibbing, MN 55746 | 2009-06-10 |
| 1962666461 | Sereen Danielle Sharp | Internal Medicine | 3605 Mayfair Avenue, Hibbing, MN 55746 | 2008-07-14 |
| 1790999274 | Raymond N Sampson | Psychologist | 914 Minnesota St, Hibbing, MN 55746 | 2007-05-10 |
| 1598985517 | Renee Cook | Psychiatry & Neurology | 3203 W. 3rd Ave., Range Mental Health Center-perpich Building, Hibbing, MN 55746 | 2007-05-01 |
| 1841318599 | Nathan Pedersen | Dentist | 802 W 42nd St, Hibbing, MN 55746 | 2007-03-27 |
| 1558406355 | Michael John Quirk | Chiropractor | 1406 East 40th St, Hibbing, MN 55746 | 2007-02-20 |
| Find all providers in zip 55746 | ||||
| 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 |
|---|---|---|---|---|
| 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.