Individual provider Active NPI

Michael A Rethwill, MD

  • Family Medicine Physician
  • Maplewood, MN
National Provider Identifier
1083686281
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25731 Issued in MN
Practice address
2165 White Bear Avenue
Mail Stop 31600a
Maplewood, MN 55109-2798
Phone
(651) 779-1500
Fax
(651) 770-3371
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25731 MN Primary

Addresses

Primary practice location

2165 White Bear Avenue
Mail Stop 31600a
Maplewood, MN 55109-2798

Mailing address

8100 34TH Ave S
Mail Stop 21110Q
Bloomington, MN 55425-1672
Phone (952) 883-5463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25731MNMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1083686281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 34TH AVE S",
            "address_2": "MAIL STOP 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251672",
            "telephone_number": "952-883-5463",
            "fax_number": "952-883-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 WHITE BEAR AVENUE",
            "address_2": "MAIL STOP 31600A",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092798",
            "telephone_number": "651-779-1500",
            "fax_number": "651-770-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETHWILL",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "25731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.