NPIMap

Individual provider Active NPI

Cody D. Tidwell, MD

  • Pain Medicine (Anesthesiology) Physician
  • Minneapolis, MN
National Provider Identifier
1033672837
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
77909 Issued in MN
Practice address
420 Delaware St SE
Minneapolis, MN 55455-0341
Phone
(612) 625-4116
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 13284677-1205 UT
Pain Medicine (Anesthesiology) Physician 207LP2900X 13284677-1205 UT
Pain Medicine (Anesthesiology) Physician 207LP2900X 77909 MN Primary

Addresses

Primary practice location

420 Delaware St SE
Minneapolis, MN 55455-0341

Mailing address

420 Delaware St SE
Minneapolis, MN 55455-0341

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ctidwell637030@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230721003118 UT Practitioner - Anesthesiology 6204163876 Reassigns benefits to 1 organization
I20240912003658 MN Practitioner - Anesthesiology 6204163876 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Anesthesia Providers LLCGroup PAC ID 7315986064, 325 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-4097

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13284677-1205UTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesia Providers, LLC Anesthesiology CurrentSince Sep 15, 2024 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc Anesthesiology CurrentSince Sep 30, 2024 Accepting new patients
University of Minnesota Physicians CurrentSince Sep 30, 2024 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Minnesota Physicians CurrentSince Sep 30, 2024 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Sep 30, 2024 Accepting new patients
Fairview Express Care CurrentSince Sep 30, 2024 Accepting new patients
University of Utah Adult Services CurrentSince Jun 1, 2023 Accepting new patients
University of Utah Adult Services CurrentSince Jun 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Sep 30, 2024 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

14500 99th Ave N
Ste 500
Maple Grove, MN 55369
Phone (763) 898-1400

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

420 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-6483

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

5200 Fairview Blvd
Ste F
Wyoming, MN 55092
Phone (612) 273-5400

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: ctidwell637030@direct.med.utah.edu

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1033672837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-625-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "CODY",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "13284677-1205",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "UT",
            "license": "13284677-1205",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MN",
            "license": "77909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctidwell637030@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.