Individual provider Active NPI

Nancy J Mendelsohn, MD

  • Clinical Genetics (M.D.) Physician
  • Saint Paul, MN
National Provider Identifier
1033106091
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
35955 Issued in MN
Practice address
347 Smith Ave N
Saint Paul, MN 55102-2387
Phone
(651) 220-6884
Fax
(651) 220-6248
NPI assigned
Oct 4, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 35955 MN Primary

Addresses

Primary practice location

347 Smith Ave N
Saint Paul, MN 55102-2387

Mailing address

2910 Centre Pointe Dr
Ste 35-121a
Roseville, MN 55113-1182
Phone (651) 855-2327

Other identifiers 1

IdentifierTypeStateIssuer
085068300MedicaidMN

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
I20040721000819 MN Practitioner - Pediatric Medicine 2062492069 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35955MNMDClinical Genetics (M.D.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gillette Children's Specialty Healthcare CurrentSince Apr 8, 2009 Accepting new patients
Childrens Health Care CurrentSince Oct 8, 2009 Accepting new patients
Childrens Health Care CurrentSince Oct 8, 2009 Accepting new patients
Childrens Health Care Current Accepting new patients
Gillette Children's Specialty Healthcare CurrentSince Apr 8, 2009 Accepting new patients

Locations

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

Organizations & group practices 5

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033106091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 CENTRE POINTE DR",
            "address_2": "STE 35-121A",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131182",
            "telephone_number": "651-855-2327",
            "fax_number": "651-855-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022387",
            "telephone_number": "651-220-6884",
            "fax_number": "651-220-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDELSOHN",
        "first_name": "NANCY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "MN",
            "license": "35955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085068300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.