NPIMap

Individual provider Active NPI

Peter Michael Yawn, M.D.

  • Family Medicine Physician
  • Blaine, MN
National Provider Identifier
1093724825
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
48807 Issued in MN
Practice address
1420 109TH Ave NE
Blaine, MN 55449-3602
Phone
(763) 581-5550
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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 48807 MN Primary

Addresses

Primary practice location

1420 109TH Ave NE
Blaine, MN 55449-3602

Mailing address

1420 109TH Ave NE
Suite 100
Blaine, MN 55449-3602
Phone (763) 581-5550

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
I20060818000023 MN Practitioner - Family Practice 6901809664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

9300 Noble Pkwy N
Brooklyn Park, MN 55443-5500
Phone (763) 236-5300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48807MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Allina Health System CurrentSince Jul 1, 2024 Accepting new patients
Allina Health System Family Medicine Current Accepting new patients
Allina Health System Family Medicine Past Accepting new patients
University of Minnesota Physicians Past Accepting new patients
Allina Health System Past Accepting new patients
North Clinic, PA Family Medicine Past Accepting new patients

Locations

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

9300 Noble Pkwy N
Minneapolis, MN 55443
Phone (763) 236-5300

10705 Town Square Dr NE
Ste 100
Minneapolis, MN 55449
Phone (763) 236-5400

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

Interoperability endpoints

  • Direct secure messaging: pyawn663685@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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1093724825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 109TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554493602",
            "telephone_number": "763-581-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 109TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554493602",
            "telephone_number": "763-581-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAWN",
        "first_name": "PETER",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "48807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.