NPIMap

Organization Active NPI

Children's Respiratory & Critical Care Specialists. P.a.

  • Pediatric Pulmonology Physician
  • Minneapolis, MN
National Provider Identifier
1003816505
Registry record updated Sep 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
62826 Issued in MN
Legal business name
CHILDREN'S RESPIRATORY & CRITICAL CARE SPECIALISTS. P.A.
Practice address
2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4570
Phone
(612) 813-3300
Fax
(612) 813-3349
NPI assigned
Jul 26, 2005
Last updated
Sep 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2017

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

Authorized official

Name
Mr. Michael Foley
Title
Administrator
Phone
(612) 813-3324

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 62826 MN
Pediatric Pulmonology Physician 2080P0214X 62826 MN Primary

Addresses

Primary practice location

2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4570

Mailing address

2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4387
Phone (612) 813-3300

Other identifiers 1

IdentifierTypeStateIssuer
1003816505MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040909000134 MN Part B Supplier - Clinic/Group Practice 8022084235 Receives reassigned benefits from 38 practitioners
Practice locations: Minneapolis, MN; Robbinsdale, MN; Saint Cloud, MN; Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

6060 Clearwater Dr
Ste 200
Hopkins, MN 55343
Phone (952) 930-8770

2530 Chicago Ave
Ste 400
Minneapolis, MN 55404
Phone (612) 813-3300

2545 Chicago Ave
Ste 617
Minneapolis, MN 55404
Phone (612) 863-3226

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504224000000",
    "number": "1003816505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044387",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044570",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S RESPIRATORY & CRITICAL CARE SPECIALISTS. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2017-09-01",
        "status": "A",
        "authorized_official_last_name": "FOLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "612-813-3324",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "62826",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "MN",
            "license": "62826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003816505",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.