Individual provider Active NPI

Patrick Carney, M.D.

  • Dermatology Physician
  • Edina, MN
National Provider Identifier
1073545901
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
31188 Issued in MN
Practice address
7373 France Ave S Ste 110
Edina, MN 55435-4538
Phone
(952) 831-8228
Fax
(952) 831-0822
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 31188 MN Primary

Addresses

Primary practice location

7373 France Ave S Ste 110
Edina, MN 55435-4538

Mailing address

820 Springer Dr
Lombard, IL 60148-6413
Phone (815) 744-8554

Other identifiers 5

IdentifierTypeStateIssuer
116814D447OtherMNUCARE
HP13038OtherMNHEALTH PARTNERS
300307OtherMNMEDICA
493001OtherMNPREFERRED ONE
1G104CAOtherMNBCBS

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
I20050131000134 MN Practitioner - Dermatology 6002719614 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31188MNMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Dermatology, SC Dermatology CurrentSince Dec 24, 2019 Accepting new patients

Locations

625 E Nicollet Blvd
Ste 203
Burnsville, MN 55337
Phone (952) 435-2525

7373 France Ave S
Ste 110
Edina, MN 55435
Phone (763) 231-8700

4725 36th Ave N
Minneapolis, MN 55422
Phone (763) 231-8700

3655 Plymouth Blvd
Ste 110
Plymouth, MN 55446
Phone (612) 486-4200

779 Bielenberg Dr
Ste 108
Woodbury, MN 55125
Phone (763) 231-8700

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1073545901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SPRINGER DR",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486413",
            "telephone_number": "815-744-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 FRANCE AVE S STE 110",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354538",
            "telephone_number": "952-831-8228",
            "fax_number": "952-831-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEY",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "31188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "116814D447",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP13038",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "300307",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "493001",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1G104CA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.