Active NPI
Michael J Tully, MD
- Anesthesiology Physician
- Robbinsdale, MN
National Provider Identifier
1083669261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 43460
- Practice address
- 3300 Oakdale Ave N
Robbinsdale, MN 55422-2926 - Phone
- (763) 520-5370
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Robbinsdale, MN
- NPI 1013960798
NPD ANESTHESIOLOGY -
- Clinic/Center
- Blaine, MN
- NPI 1841995552
-
- General Acute Care Hospital
- Robbinsdale, MN
- NPI 1851344907
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Memorial Health Care | Current |
Accepting new patients | |
| Anesthesiology, P.a. | Anesthesiology | Current |
Accepting new patients |
| North Memorial Health Care | Current | Accepting new patients |
Locations
9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000
2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000
14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779
3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 43460 | MN | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Mailing address
14700 28TH Ave N
Suite 20
Plymouth, MN 55447-4835
Phone (763) 559-3779
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 13, 2026.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1083669261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14700 28TH AVE N",
"address_2": "SUITE 20",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554474835",
"telephone_number": "763-559-3779",
"fax_number": "763-450-3986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 OAKDALE AVE N",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554222926",
"telephone_number": "763-520-5370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLY",
"first_name": "MICHAEL",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MN",
"license": "43460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Robbinsdale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.