Individual provider Active NPI

Richard M. Levinson, M.D.

  • Pediatric Otolaryngology Physician
  • Minneapolis, MN
National Provider Identifier
1003818824
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
24333 Issued in MN
Practice address
2211 Park Ave
Minneapolis, MN 55404-3711
Phone
(612) 871-1144
Fax
(612) 871-2012
NPI assigned
Aug 11, 2005
Last updated
May 21, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 24333 MN Primary

Addresses

Primary practice location

2211 Park Ave
Minneapolis, MN 55404-3711

Mailing address

2211 Park Ave
Minneapolis, MN 55404-3711
Phone (612) 871-1144

Other identifiers 8

IdentifierTypeStateIssuer
09846LEOtherMNBLUE SHIELD
30284300OtherWIMEDICAID - WISCONSIN
88313OtherMNAMERICA'S PPO
402792200MedicaidMN
1000010OtherMNMEDICA PRIMARY
100645OtherMNUCARE
0098003OtherMNPREFERREDONE
1003802OtherMNMEDICA CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose & Throat Specialty Care of Minnesota PA CurrentSince Jan 1, 2022 Accepting new patients

Locations

9550 Upland Ln N
Ste 200
Maple Grove, MN 55369
Phone (612) 871-1144

2211 Park Ave
Minneapolis, MN 55404
Phone (612) 871-1144

6099 Wayzata Blvd
Ste 200
St Louis Park, MN 55416
Phone (612) 871-1144

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1003818824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043711",
            "telephone_number": "612-871-1144",
            "fax_number": "612-871-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043711",
            "telephone_number": "612-871-1144",
            "fax_number": "612-871-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINSON",
        "first_name": "RICHARD",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MN",
            "license": "24333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "09846LE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - WISCONSIN",
            "identifier": "30284300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "88313",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402792200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PRIMARY",
            "identifier": "1000010",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "100645",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "0098003",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "1003802",
            "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 May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.