Active NPI
Marilyn Susan Joseph, MD
- Obstetrics & Gynecology Physician
- Minneapolis, MN
National Provider Identifier
1033202981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 21274
- Practice address
- 410 Church St SE
Boynton Health Service
Minneapolis, MN 55455-0340 - Phone
- (612) 625-5187
- Fax
- (612) 625-0902
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 21274 | MN | Primary |
Addresses
Primary practice location
410 Church St SE
Boynton Health Service
Minneapolis, MN 55455-0340
Mailing address
410 Church St SE
Boynton Health Service
Minneapolis, MN 55455-0340
Phone (612) 625-5187
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2T433JO | Other | MN | BCBS |
| HP16488 | Other | MN | HEALTH PARTNERS |
| 0770062 | Other | MN | MEDICA-PRIMARY |
| 100734 | Other | MN | U CARE |
| 10387 | Medicaid | ND | |
| 0541011 | Medicaid | IA | |
| 1000089 | Other | MN | PREFERRED ONE |
| 013847 | Other | MN | FAIRVIEW |
| 7777470 | Medicaid | SD | |
| 07-24902 | Other | MN | MEDICA-CHOICE |
| 30199300 | Medicaid | WI | |
| 764324 | Other | ARAZ |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Minnesota Physicians | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033202981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 CHURCH ST SE",
"address_2": "BOYNTON HEALTH SERVICE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550340",
"telephone_number": "612-625-5187",
"fax_number": "612-625-0902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 CHURCH ST SE",
"address_2": "BOYNTON HEALTH SERVICE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550340",
"telephone_number": "612-625-5187",
"fax_number": "612-625-0902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "MARILYN",
"middle_name": "SUSAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MN",
"license": "21274",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "2T433JO",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP16488",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA-PRIMARY",
"identifier": "0770062",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U CARE",
"identifier": "100734",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10387",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0541011",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1000089",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FAIRVIEW",
"identifier": "013847",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7777470",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA-CHOICE",
"identifier": "07-24902",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30199300",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "764324",
"state": null
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.