Active NPI
Jose Ernesto Molina, MD
- Surgery Physician
- Minneapolis, MN
National Provider Identifier
1053416677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 20085
- Practice address
- 516 Delaware St SE
PWB Third Floor, Clinic 3B
Minneapolis, MN 55455-0356 - Phone
- (612) 625-3600
- NPI assigned
- Sep 14, 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 20085 | MN | Primary |
Addresses
Primary practice location
516 Delaware St SE
PWB Third Floor, Clinic 3B
Minneapolis, MN 55455-0356
Mailing address
420 Delaware Street Semmc 292
University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 625-3600
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 154095500 | Medicaid | MN | |
| 2T100MO | Other | MN | BLUE CROSS BLUE SHIELD |
| 079814 | Other | MN | FAIRVIEW |
| 18-22598 | Other | MN | MEDICA CHOICE |
| 0997775 | Medicaid | IA | |
| 1009247 | Other | MN | PREFERRED ONE |
| HP22192 | Other | MN | HEALTH PARTNERS |
| 768275 | Other | MN | ARAZ |
| 101590 | Other | MN | UCARE |
| 18-00014 | Other | MN | MEDICA PRIMARY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351209600000",
"number": "1053416677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 DELAWARE STREET SEMMC 292",
"address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-625-3600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 DELAWARE ST SE",
"address_2": "PWB THIRD FLOOR, CLINIC 3B",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550356",
"telephone_number": "612-625-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLINA",
"first_name": "JOSE",
"middle_name": "ERNESTO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2012-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "20085",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "154095500",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "2T100MO",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FAIRVIEW",
"identifier": "079814",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA CHOICE",
"identifier": "18-22598",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0997775",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1009247",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP22192",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "768275",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "101590",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA PRIMARY",
"identifier": "18-00014",
"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 Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.