Active NPI
Edward A Juodis, MD
- Diagnostic Radiology Physician
- Minneapolis, MN
National Provider Identifier
1053403980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 41300
- Practice address
- 500 Harvard St SE
Unit J2-300 University of Minnesota Physicians
Minneapolis, MN 55455 - Phone
- (612) 273-6004
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 41300 | MN | Primary |
Addresses
Primary practice location
500 Harvard St SE
Unit J2-300 University of Minnesota Physicians
Minneapolis, MN 55455
Mailing address
420 Delaware St SE
MMC 292 University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 273-6004
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1021554 | Other | MN | PREFERRED ONE |
| 16-00398 | Other | MN | MEDICA-CHOICE |
| 0054009 | Medicaid | MT | |
| 16-02032 | Other | MN | MEDICA-PRIMARY |
| 930064 | Other | ARAZ | |
| 59R93JU | Other | MN | BLUE CROSS BLUE SHIELD |
| HP38351 | Other | MN | HEALTHPARTNERS |
| 123469 | Other | MN | U CARE |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41300 | MN | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402358400000",
"number": "1053403980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 DELAWARE ST SE",
"address_2": "MMC 292 UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-273-6004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 HARVARD ST SE",
"address_2": "UNIT J2-300 UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-273-6004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUODIS",
"first_name": "EDWARD",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2014-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MN",
"license": "41300",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1021554",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA-CHOICE",
"identifier": "16-00398",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0054009",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA-PRIMARY",
"identifier": "16-02032",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "930064",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "59R93JU",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP38351",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U CARE",
"identifier": "123469",
"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 Jun 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.