Individual provider Active NPI

Stephanie Terezakis, MD

  • Radiation Oncology Physician
  • Minneapolis, MN
National Provider Identifier
1053550228
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
64832 Issued in MN
Practice address
500 Harvard St SE
Minneapolis, MN 55455-0363
Phone
(612) 273-6700
NPI assigned
Feb 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X D68563 MD
Therapeutic Radiology Physician 2085R0203X 237510 NY
Radiation Oncology Physician 2085R0001X 64832 MN Primary

Addresses

Primary practice location

500 Harvard St SE
Minneapolis, MN 55455-0363

Mailing address

720 Washington Ave SE Ste 300
Minneapolis, MN 55414-2904

Other identifiers 1

IdentifierTypeStateIssuer
023184300MedicaidMD

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
I20181218001662 MN Practitioner - Radiation Oncology 5496807364 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Johns Hopkins University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
University of Minnesota PhysiciansGroup PAC ID 9830001189, 158 clinicians

Practice addresses (Care Compare)

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (855) 324-7843

2450 Riverside Ave
Minneapolis, MN 55454-1450

5160 Fairview Blvd
Suite 1200
Wyoming, MN 55092-8050
Phone (651) 982-3520

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D68563MDMDRadiation Oncology Physician
237510NYMDTherapeutic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Physicians Current Accepting new patients
Healtheast St. John'S Hospital CurrentSince Feb 1, 2019 Accepting new patients
Fairview Health Services CurrentSince Feb 2, 2019 Accepting new patients
Fairview Health Services CurrentSince Feb 2, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Clinics CurrentSince May 19, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Clinics CurrentSince May 19, 2021 Accepting new patients
University of Minnesota Physicians CurrentSince Jan 21, 2019 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Feb 1, 2019 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Fairview Bethesda Hospital CurrentSince Feb 1, 2019 Accepting new patients
Healtheast Care System CurrentSince Feb 1, 2019 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 1, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

14500 99th Ave N
Maple Grove, MN 55369
Phone (763) 898-1000

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

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

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

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

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

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

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

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

5160 Fairview Blvd
Ste 1200
Wyoming, MN 55092
Phone (651) 982-3520

Interoperability endpoints

  • Direct secure messaging: sterezakis460176@fairview.direct-ci.com

Organizations & group practices 19

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 19

Hospital & facility affiliations 3

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": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1053550228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HARVARD ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550363",
            "telephone_number": "612-273-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEREZAKIS",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MD",
            "license": "D68563",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "NY",
            "license": "237510",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MN",
            "license": "64832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023184300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.