DR. BORIS MICHAEL BECKERT (NPI# 1528059375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528059375 |
| Entity Type | Individual |
| Full Name | DR. BORIS MICHAEL BECKERT |
| Credential | MD |
| Practice Address |
600 W 98th St Bloomington MN 55420-4773 |
| Mailing Address |
2406 W Broadway Jencare Neighborhood Medical Center West Broadway, LLC Louisville KY 40211-1008 |
| Practice Telephone | 5027751211 |
| Practice Fax Number | 5027751221 |
| Mailing Telephone | 5027751211 |
| Mailing Fax Number | 5027751221 |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2019-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 41127 | WI | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 35570 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32020800 | 05 | |
| MN | 766363300 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2945 Hazelwood St Ste 100, Maplewood, MN 551091242 | 6512327800 | 6512327940 |
| 1217 Eighth Street North, New Ulm, MN 560734773 | 5072175000 |
| Street Address |
600 W 98TH ST |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55420-4773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023017084 | Michelle Svihel | Physician Assistant | 600 W 98th St, Bloomington, MN 55420-4773 | 2005-07-20 |
| 1326568668 | Adele Michiko Langeness | Physician Assistant | 600 W 98th St, Bloomington, MN 55420-4773 | 2017-06-27 |
| 1124559893 | Bryan Labore | Internal Medicine | 600 W 98th St, Bloomington, MN 55420-4773 | 2017-03-24 |
| 1033563572 | Alice Catherine Lehman | Pediatrics | 600 W 98th St, Bloomington, MN 55420-4773 | 2016-04-21 |
| 1861858953 | Fairview Health Services | Clinic/Center | 600 W 98th St, Bloomington, MN 55420-4773 | 2016-01-06 |
| 1679950968 | Brian Francis Allen | Family Medicine | 600 W 98th St, Bloomington, MN 55420-4773 | 2015-05-06 |
| 1528452935 | Sigrid Mae Casey Avenido | Physician Assistant | 600 W 98th St, Bloomington, MN 55420-4773 | 2015-03-24 |
| 1447670948 | Claire Kathleen Mcneil | Internal Medicine | 600 W 98th St, Bloomington, MN 55420 | 2014-04-23 |
| 1578991352 | Tara Ettestad | Dietitian, Registered | 600 W 98th St, Bloomington, MN 55420 | 2013-10-14 |
| 1700227600 | Fairview Clinics | Specialist | 600 W 98th St, Suite 315, Bloomington, MN 55420-4773 | 2013-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457986556 | Jon Brookson Engfer | Counselor | 8609 Lyndale Avenue South, Bloomington, MN 55420 | 2020-03-09 |
| 1720624810 | Sunshine Assisted Living Services LLC | Home Health | 9540 Columbus Ave S, Bloomington, MN 55420 | 2019-11-23 |
| 1417205246 | Jrb Holdings, LLC | Home Health | 9897 Lyndale Ave S, Bloomington, MN 55420 | 2012-08-28 |
| 1629223722 | Jennifer Jean Bormann | Audiologist | 8714 Lyndale Avenue South, Minneapolis, MN 55420 | 2008-11-18 |
| 1801055959 | Sarah J. Marsden | Speech-Language Pathologist | 900 W 94th St., Bloomington, MN 55420 | 2008-06-04 |
| 1699949784 | 1st Choice Care, Inc. | Home Health | 9035 Blaisdell Ave S, Bloomington, MN 55420 | 2008-04-18 |
| 1922295203 | Cornerstone Advocacy Service | Community/Behavioral Health | 1000 East 80th St, Bloomington, MN 55420 | 2007-10-01 |
| 1184769457 | Fairview Oxboro Pharmacy Mtm | Non-Pharmacy Dispensing Site | 600 W 98th Street, Bloomington, MN 55420 | 2007-02-21 |
| 1891831723 | A Caring Company, Inc. | In Home Supportive Care | 9001 East Bloomington Freeway, Sutie 145, Bloomington, MN 55420 | 2007-01-29 |
| 1134279318 | Jennifer Mary Connelly | Speech-Language Pathologist | 9001 E Bloomington Fwy Ste 141, Bloomington, MN 55420 | 2007-01-11 |
| Find all providers in zip 55420 | ||||
| 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 |
|---|---|---|---|---|
| 1073165650 | Genevieve Elon Monge | Family Medicine | 18651 Valley Blvd, Bloomington, CA 92316-1831 | 2019-07-12 |
| 1982117172 | Andry Medical Services | Family Medicine | 451 S Park Ridge Rd Ste 101, Bloomington, IN 47401-8589 | 2017-11-09 |
| 1033459904 | Charles R Farmer | Family Medicine | 3480 S Oak Ridge Dr, Bloomington, IN 47401-8926 | 2013-02-28 |
| 1467798504 | James Anthony Ray | Family Medicine | 2001 E Hillside Dr Lot 4, Bloomington, IN 47401-6692 | 2012-12-18 |
| 1902140585 | Fountain Healthcare Limited Liability Company | Family Medicine | 2412 E Washington St Ste 6, Bloomington, IL 61704-4497 | 2012-11-20 |
| 1306147236 | Community Health Network | Family Medicine | 524 N Fairview St, Bloomington, IN 47404-3774 | 2010-11-09 |
| 1942501978 | Premier Medical Group, LLC | Family Medicine | 2102 E Washington St, Bloomington, IL 61701-4321 | 2010-11-08 |
| 1356660666 | Glen Edward Tomlinson | Family Medicine | 42 Crista Ann Ct, Bloomington, IL 61704-8699 | 2010-05-26 |
| 1285862664 | Charles W Mcclary | Family Medicine | 1411 S Sare Rd, Bloomington, IN 47401-4431 | 2009-06-24 |
| 1982840005 | Thomas Patterson Cairns | Family Medicine | 10258 Berkshire Rd, Bloomington, MN 55437-2265 | 2008-12-18 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 55420 |
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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.