NPIMap

Individual provider Active NPI

Shannon Elizabeth Hayes, M.D.

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1053600585
Registry record updated Dec 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
58355 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(952) 967-7977
Fax
(651) 254-9673
NPI assigned
Apr 5, 2011
Last updated
Dec 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 58355 MN Primary
Internal Medicine Physician 207R00000X 107670 MN
Hospitalist Physician 208M00000X 58355 MN

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516
Phone (952) 967-7977

Other practice location 1

3300 Oakdale Avenue North
Robbinsdale, MN 55422
Phone (612) 873-2300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140721001206 MN Practitioner - Internal MedicinePractitioner - Hospitalist 8820214224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (612) 427-2200

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107670MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Dec 23, 2020 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Dec 23, 2020 Accepting new patients
Allina Health System Past Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1053600585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-967-7977",
            "fax_number": "651-254-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "952-967-7977",
            "fax_number": "651-254-9673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Oakdale Avenue North",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "55422",
            "country_code": "US",
            "telephone_number": "612-873-2300",
            "fax_number": "612-904-4358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYES",
        "first_name": "SHANNON",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "58355",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "107670",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "58355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.