NPIMap

Individual provider Active NPI

Matthew Allen Danielson, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Coon Rapids, MN
National Provider Identifier
1073879433
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
60716 Issued in MN
Practice address
11850 Blackfoot St NW Ste 405
Coon Rapids, MN 55433-2773
Phone
(763) 236-0888
NPI assigned
Apr 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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
Physical Medicine & Rehabilitation Physician 208100000X 60716 MN Primary

Addresses

Primary practice location

11850 Blackfoot St NW Ste 405
Coon Rapids, MN 55433-2773

Mailing address

800 N 3Rd St Apt 225
Minneapolis, MN 55401-2675
Phone (608) 234-0793

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
I20160726002085 MN Practitioner - Physical Medicine and Rehabilitation 0042443970 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Medical College of Wisconsin, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

11850 Blackfoot St NW
Suite 405
Coon Rapids, MN 55433-2773
Phone (612) 775-6200

800 E 28TH St
Suite 1750
Minneapolis, MN 55407-3723
Phone (612) 863-4495

Hospital & facility affiliations

  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115
  • Abbott Northwestern Hospital Inpatient rehabilitation facility, Minneapolis, MN, CCN 24T057

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60716MNMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System Physical Medicine & Rehabilitation CurrentSince Aug 1, 2016 Accepting new patients
Allina Health System CurrentSince Jan 18, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Aug 1, 2016 Accepting new patients
Allina Health System Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

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

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

11850 Blackfoot St NW
Ste 405
Minneapolis, MN 55433
Phone (763) 236-0888

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

800 E 28th St
Ste 1750
Minneapolis, MN 55407
Phone (612) 863-4495

1021 Bandana Blvd E
Ste 100
Saint Paul, MN 55108
Phone (877) 414-2533

280 Smith Ave N
Ste 220
Saint Paul, MN 55102
Phone (651) 241-8295

Interoperability endpoints

  • Direct secure messaging: mdanielson324939@excellian.direct.allina.com

Organizations & group practices 7

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.

Hospital & facility affiliations 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1073879433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N 3RD ST APT 225",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012675",
            "telephone_number": "608-234-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW STE 405",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332773",
            "telephone_number": "763-236-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSON",
        "first_name": "MATTHEW",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MN",
            "license": "60716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.