Individual provider Active NPI

Robert W Nipp, DPM

  • Podiatrist
  • Duluth, MN
National Provider Identifier
1073561437
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
496 Issued in MN
Practice address
324 W Superior St
Ste 408
Duluth, MN 55805
Phone
(218) 722-0615
Fax
(218) 722-6712
NPI assigned
May 5, 2006
Last updated
May 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 496 MN Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 496 MN

Addresses

Primary practice location

324 W Superior St
Ste 408
Duluth, MN 55805

Mailing address

324 W Superior St
Ste 408
Duluth, MN 55805
Phone (218) 722-0615

Other identifiers 2

IdentifierTypeStateIssuer
634525500MedicaidMN
5B969NOOtherBCBS

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101115001222 MN Practitioner - Podiatry 5294768214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Foot and Ankle Associates PAGroup PAC ID 8527091537, 3 clinicians

Practice addresses (Care Compare)

324 W Superior St
Suite 408
Duluth, MN 55802-1726
Phone (218) 722-0615

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue158
Removal of skin lesions12
Removal of nail tissue351
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
496MNMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Foot & Ankle Associates PA Podiatrist CurrentSince Jul 1, 1993 Accepting new patients

Locations

324 W Superior St
Ste 408
Duluth, MN 55802
Phone (218) 722-0615

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, 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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1073561437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST",
            "address_2": "STE 408",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-722-0615",
            "fax_number": "218-722-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST",
            "address_2": "STE 408",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-722-0615",
            "fax_number": "218-722-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIPP",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "496",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MN",
            "license": "496",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "634525500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5B969NO",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.