DR. ILYA PEREPELITSYN (NPI# 1992795058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992795058 |
| Entity Type | Individual |
| Full Name | DR. ILYA PEREPELITSYN |
| Credential | MD |
| Practice Address |
2211 Park Ave Minneapolis MN 55404-3711 |
| Practice Telephone | 6128711144 |
| Practice Fax Number | 6128712012 |
| Mailing Telephone | 6128711144 |
| Mailing Fax Number | 6128712012 |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2013-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
49351 | MN | Allopathic & Osteopathic Physicians |
| N | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
219565 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BLUE CROSS BLUE SHIELD | J27270 | 01 |
| MN | 305473200 | 05 | |
| WI | 34756700 | 05 | |
| MA | HARVARD PILGRIM | AA11436 | 01 |
| Street Address |
2211 PARK AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55404-3711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508867003 | Karin E. Evan | Otolaryngology | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2005-08-09 |
| 1033761267 | Gabrielle Kristin Tachenko | Audiologist | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2019-07-09 |
| 1265885149 | Diana Kathryn Weissbeck | Audiologist-Hearing Aid Fitter | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2016-07-15 |
| 1609221191 | Melanie Vanden Heuvel | Audiologist | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2016-05-03 |
| 1891089850 | Nathan Daniel Johnson | Otolaryngology | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2011-06-07 |
| 1295026540 | Courtney Anne Hill | Otolaryngology | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2011-04-20 |
| 1649590076 | Nathan Martin Schularick | Otolaryngology | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2010-06-08 |
| 1164693099 | Kelly M Shook | Audiologist | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2008-03-19 |
| 1992904684 | Mary J Ring | Audiologist | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2007-07-13 |
| 1982783833 | Mary Beth Trine | Audiologist | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2006-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1760969125 | Bethany Karen Kenny | Registered Nurse | 910 E 26th St Ste 200, Minneapolis, MN 55404 | 2018-07-27 |
| 1225535701 | Karissa Dougherty | Nurse Practitioner | 2200 E Franklin Ave # 199, Minneapolis, MN 55404 | 2018-04-10 |
| 1891299491 | Guidance Home Health Care LLC | Home Health | 2529 Nicollet Avenue 202b, Minneapolis, MN 55404 | 2018-03-20 |
| 1770085490 | Bright Future Counseling Service, LLC | Counselor | 912 E. 24th St., Suite B215, Minneapolis, MN 55404 | 2018-03-08 |
| 1346754298 | Juba Pharmacy Inc | Pharmacy | 1926 Chicago Ave S, Minneapolis, MN 55404 | 2017-11-29 |
| 1629597323 | Kira Larson Fieldstrom | Social Worker | 2400 Blaisdell Ave., Minneapolis, MN 55404 | 2017-09-13 |
| 1770008930 | Nicole Lynn Sparks | Social Worker | 2445 Park Avenue, Minneapolis, MN 55404 | 2017-08-09 |
| 1639612765 | Cosmo Home Healthcare Services, L.L.C. | Home Health | 2219 Oakland Ave S, Suite 104, Minneapolis, MN 55404 | 2016-11-21 |
| Find all providers in zip 55404 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477782738 | William Douglas Richards | Otolaryngology | 111 17th Ave E Ste 1, Alexandria, MN 56308-0057 | 2009-07-08 |
| 1609035781 | John Luther Boone | Otolaryngology | 6525 France Ave S Ste 325, Edina, MN 55435-2187 | 2008-06-04 |
| 1396181483 | Fareeda Taher Nazer Hussain | Otolaryngology | 1025 Marsh St, Mankato, MN 56001 | 2013-05-15 |
| 1730450297 | Prischmann Facial Plastic Surgery, Pllc | Otolaryngology | 5201 Eden Ave, Suite 170, Edina, MN 55436-2316 | 2012-01-15 |
| 1558688366 | Bryan Nicholas Rolfes | Otolaryngology | 935 Wayzata Blvd E Ste 200, Wayzata, MN 55391-2513 | 2010-05-03 |
| 1407947518 | Gary Edwin Schnitker | Otolaryngology | 7300 France Ave S, Suite #100, Edina, MN 55435-4525 | 2006-09-27 |
| City | MINNEAPOLIS |
| Zip Code | 55404 |
Please comment or provide details below to improve the information on DR. ILYA PEREPELITSYN.
| 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.