DR. ALEC DAVID OTTEMAN (NPI# 1619138849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619138849 |
| Entity Type | Individual |
| Full Name | DR. ALEC DAVID OTTEMAN |
| Credential | M.D. |
| Practice Address |
2854 Highway 55 Suite 130 Eagan MN 55121-2156 |
| Mailing Address |
360 Sherman St Suite 250 Saint Paul MN 55102-2564 |
| Practice Telephone | 6518423378 |
| Practice Fax Number | 6512245273 |
| Mailing Telephone | 6517726251 |
| Mailing Fax Number | 6512249661 |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2013-05-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 52024 | MN | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
52024 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
2854 HIGHWAY 55 SUITE 130 |
| City | EAGAN |
| State | MN |
| Zip Code | 55121-2156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962446781 | Capitol Anesthesia Services P.a. | Nurse Anesthetist, Certified Registered | 2854 Highway 55, Suite 130, Eagan, MN 55121-1405 | 2006-06-15 |
| 1730485582 | Lake City Family Physicians PC | Family Medicine | 2854 Highway 55, Suite 130, Eagan, MN 55121-2156 | 2011-01-26 |
| 1306149539 | Kathryn Susan Eisenmenger Fuentes | Physician Assistant | 2854 Highway 55, Suite 130, Eagan, MN 55121-2156 | 2010-12-09 |
| 1841590767 | One T Counseling, Consultation, Training, Publishing & Productions | Counselor | 2854 Highway 55, Suite 130, Eagan, MN 55121-1776 | 2010-10-26 |
| 1265688089 | Mark W. Erhard, M.d., P.a. | Internal Medicine | 2854 Highway 55, Suite #130, Eagan, MN 55121-2156 | 2008-08-12 |
| 1023274479 | Lyle J. Swenson, M.d, P.a | Internal Medicine | 2854 Highway 55, Suite #130, Eagan, MN 55121-2156 | 2008-08-05 |
| 1316130560 | Hodges Surgical Clinic, P.a. | Clinic/Center | 2854 Highway 55, Suite #130, Eagan, MN 55121-2156 | 2007-08-21 |
| 1659396000 | David J Ridley | Internal Medicine | 2854 Highway 55, Suite 190, Eagan, MN 55121-2156 | 2006-07-13 |
| 1154354751 | Joan M Beard | Nurse Practitioner | 2854 Highway 55, Suite 190, Eagan, MN 55121-2156 | 2006-07-08 |
| 1053344788 | St Paul Rheumatology P A | Internal Medicine | 2854 Highway 55, Suite 190, Eagan, MN 55121-2156 | 2006-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443850 | Birchwood Dental, LLC | Dentist | 3356 Sherman Crt Ste 101, Eagan, MN 55121 | 2020-09-28 |
| 1811552813 | Clare Muyskens | Physical Therapist | 3305 Central Park Commons Dr, Eagan, MN 55121 | 2019-05-06 |
| 1154986479 | Elp Right Living Health LLC | Assisted Living Facility | 3035 Eagandale Pl #101, Eagan, MN 55121 | 2019-05-02 |
| 1467908699 | Hy Vee Inc | Pharmacy | 1500 Central Park Commons Drive, Eagan, MN 55121 | 2016-08-28 |
| 1962861005 | Lakeline Transportation LLC | Non-emergency Medical Transport (VAN) | 1416 Shoreline Dr, Eagan, MN 55121 | 2016-02-17 |
| 1467838615 | John Berchem | Physical Therapist | 1284 Coporate Center Drive, #500, Eagan, MN 55121 | 2015-08-10 |
| 1730426099 | Carole P Cohen | Occupational Therapist | 880 Blue Gentian Road, Ste # 190, Eagan, MN 55121 | 2013-01-07 |
| 1407102882 | Emergency Physicians Professional Association | Clinic/Center | 3010 Denmark Avenue, Eagan, MN 55121 | 2012-08-03 |
| 1851692289 | Eagan Family Chiropractic & Massage | Chiropractor | 1260 Yankee Doodle Road, Suite 100, Eagan, MN 55121 | 2010-11-17 |
| 1780805218 | Bridget Marie Mcconnell | Social Worker | 680 O'neill Drive, Eagan, MN 55121 | 2007-05-01 |
| Find all providers in zip 55121 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649723420 | Stephanie Stackhouse | Internal Medicine | 5520 Bristol Lane, Minnetonka, MN 55343 | 2016-07-28 |
| 1841652146 | Deepthi Chandra Malepati | Internal Medicine | 717 Delaware Street Se, Mail Code 1932j, Minneapolis, MN 55414 | 2016-03-25 |
| 1538459755 | Maxwell David Leither | Internal Medicine | 6200 Shingle Creek Pkwy Ste 250, Brooklyn Center, MN 55430-2107 | 2011-04-08 |
| 1063650307 | Peter Paul Frohnert | Internal Medicine | 66 9th St E, Apt. 2305, Saint Paul, MN 55101-4700 | 2009-01-24 |
| 1164690475 | Paul Christian Seel | Internal Medicine | 2 Crocus Ln, Saint Paul, MN 55127-6302 | 2008-02-20 |
| 1619023918 | Vishal Sagar | Internal Medicine | 401 Phalen Blvd - Ms 41103c, Healthpartners Specialty Center 401, Saint Paul, MN 55130-5302 | 2007-01-27 |
| 1447343330 | Mark Alan Matson | Internal Medicine | 1000 Westgate Drive, Suite 149, St. Paul, MN 55114-5000 | 2006-10-02 |
| 1205945466 | Areef Ishani | Internal Medicine | 1 Veterans Dr # 111j, Minneapolis, MN 55417-2309 | 2006-08-30 |
| 1568489540 | Francis John Tycast | Internal Medicine | 19545 W Ford Brook Dr, Anoka, MN 55303-9580 | 2006-07-16 |
| 1255305355 | Brett W Nyholm | Internal Medicine | 6200 Shingle Creek Pkwy, Suite 250, Brooklyn Center, MN 55430-2128 | 2006-02-15 |
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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.