NPIMap

Individual provider Active NPI

Nolan C Cirillo-Penn, MD

  • Vascular Surgery Physician
  • Rochester, MN
National Provider Identifier
1093210262
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
65817 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905
Phone
(507) 284-2511
NPI assigned
Mar 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 29124 MN
Vascular Surgery Physician 2086S0129X 65817 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

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
I20190807000047 MN Practitioner - Vascular Surgery 4486902541 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2018
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

Practice addresses (Care Compare)

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

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

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Fairview Northland Regional Hospital Hospital, Princeton, MN, CCN 240141
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078
  • Grand Itasca Clinic and Hospital Hospital, Grand Rapids, MN, CCN 240064
  • Essentia Health Hospital, Fargo, ND, CCN 350070

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

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65817MNMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jun 19, 2023 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jul 1, 2023 Accepting new patients
University of Minnesota Physicians CurrentSince Jun 19, 2023 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jun 19, 2023 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Express Care CurrentSince Jun 19, 2023 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jun 19, 2023 Accepting new patients
University of Minnesota Pediatric Dental Clinic CurrentSince Jun 19, 2023 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

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

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

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

Interoperability endpoints

  • Direct secure messaging: ncirillopenn792308@fairview.direct-ci.com

Organizations & group practices 12

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1093210262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55905",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRILLO-PENN",
        "first_name": "NOLAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MN",
            "license": "29124",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MN",
            "license": "65817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.