Individual provider Active NPI

Hannah Carlson-Donohoe Esdal, M.D.

  • Pediatrics Physician
  • Woodbury, MN
National Provider Identifier
1053791392
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
63048 Issued in MN
Practice address
9680 Tamarack Rd Ste 100
Woodbury, MN 55125
Phone
(651) 738-9001
NPI assigned
Jun 2, 2015
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 63048 MN Primary

Addresses

Primary practice location

9680 Tamarack Rd Ste 100
Woodbury, MN 55125

Mailing address

9680 Tamarack Rd Ste 100
Woodbury, MN 55125-2623
Phone (651) 738-9001

Other practice location 1

717 Delaware St SE
1932K (Campus Delivery Code)
Minneapolis, MN 55414-2959
Phone (612) 626-2953

Other practice location 2

7920 Old Cedar Ave S
Bloomington, MN 55425-1207
Phone (952) 428-1800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hesdal221328@excellian.direct.allina.com Direct

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
I20230223000762 MN Practitioner - Pediatric Medicine 1254639628 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63048MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Mar 24, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Mar 24, 2023 Accepting new patients
NPI 1083910871 Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

7920 Old Cedar Ave S
Minneapolis, MN 55425
Phone (952) 428-1800

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.

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1053791392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9680 TAMARACK RD STE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252623",
            "telephone_number": "651-738-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9680 TAMARACK RD STE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55125",
            "telephone_number": "651-738-9001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "717 Delaware St SE",
            "address_2": "1932K (Campus Delivery Code)",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554142959",
            "country_code": "US",
            "telephone_number": "612-626-2953",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7920 Old Cedar Ave S",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554251207",
            "country_code": "US",
            "telephone_number": "952-428-1800",
            "fax_number": "952-428-1723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESDAL",
        "first_name": "HANNAH",
        "middle_name": "CARLSON-DONOHOE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "63048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hesdal221328@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "7920 Old Cedar Ave S",
            "city": "Bloomington",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554251207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.