Individual provider Active NPI

Gennadiy Vasilyevich Shevchenko, MD

  • Neurology Physician
  • Minneapolis, MN
National Provider Identifier
1093005498
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
59255 Issued in MN
Practice address
3809 42ND Ave S
Minneapolis, MN 55406-3503
Phone
(612) 721-6261
Fax
(612) 721-1691
NPI assigned
Apr 19, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 59255 MN Primary

Addresses

Primary practice location

3809 42ND Ave S
Minneapolis, MN 55406-3503

Mailing address

3809 42ND Ave S
Minneapolis, MN 55406-3503
Phone (612) 721-6261

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
I20150828000258 MN Practitioner - Neurology 6204142763 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians

Practice addresses (Care Compare)

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (855) 324-7843

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

6545 France Ave S
Suite 125
Edina, MN 55435-2357
Phone (952) 924-5000

6545 France Ave S
Suite 150
Edina, MN 55435-2180
Phone (952) 848-5600

6545 France Ave S
Suite 450
Edina, MN 55435-2122
Phone (952) 924-1520

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Hospital & facility affiliations

  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078
  • M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Sep 10, 2016 Accepting new patients
Fairview Express Care CurrentSince Nov 1, 2020 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Insititue CurrentSince Jul 10, 2021 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Bethesda Hospital CurrentSince Jul 10, 2021 Accepting new patients
Healtheast St. John'S Hospital CurrentSince Jul 10, 2021 Accepting new patients
Fairview Health Services Current Accepting new patients
Healtheast Care System CurrentSince Jul 10, 2021 Accepting new patients
Fairview Express Care CurrentSince Nov 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Sep 10, 2016 Accepting new patients
Fairview Clinics CurrentSince Sep 10, 2016 Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jul 10, 2021 Accepting new patients
Fairview Clinics CurrentSince Sep 10, 2016 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Jul 10, 2021 Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 150
Edina, MN 55435
Phone (952) 848-5600

6545 France Ave S
Ste 125
Edina, MN 55435
Phone (952) 405-2777

6545 France Ave S
Ste 450
Edina, MN 55435
Phone (612) 626-6688

3809 42nd Ave S
Minneapolis, MN 55406
Phone (612) 407-7213

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

2270 Ford Pkwy
Ste 200
Saint Paul, MN 55116
Phone (651) 696-5000

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: gshevchenko273316@fairview.direct-ci.com

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1093005498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 42ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554063503",
            "telephone_number": "612-721-6261",
            "fax_number": "612-721-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 42ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554063503",
            "telephone_number": "612-721-6261",
            "fax_number": "612-721-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEVCHENKO",
        "first_name": "GENNADIY",
        "middle_name": "VASILYEVICH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "59255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.