Individual provider Active NPI

Mary Baumgartner, MD

  • Student in an Organized Health Care Education/Training Program
  • Saint Louis Park, MN
National Provider Identifier
1003604034
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
6600 Excelsior Blvd Ste 160
Saint Louis Park, MN 55426-4713
Phone
(952) 993-7705
NPI assigned
Apr 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

6600 Excelsior Blvd Ste 160
Saint Louis Park, MN 55426-4713

Mailing address

6600 Excelsior Blvd Ste 160
Saint Louis Park, MN 55426-4713
Phone (952) 993-7705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250708002304 MN Order and Referring Only - Family PracticePractitioner - Family Practice 6305350844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1003604034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 EXCELSIOR BLVD STE 160",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554264713",
            "telephone_number": "952-993-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 EXCELSIOR BLVD STE 160",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554264713",
            "telephone_number": "952-993-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGARTNER",
        "first_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis Park, MN

Sources for this page

Verify at the official NPI Registry.