Individual provider Active NPI

Michael B Pitt, M.D.

  • Pediatrics Physician
  • Minneapolis, MN
National Provider Identifier
1104072172
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
56404 Issued in MN
Practice address
2450 Riverside Ave
M653 East Building
Minneapolis, MN 55454-1450
Phone
(612) 624-9668
NPI assigned
Aug 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125-052976 IL
Pediatrics Physician 208000000X 56404 MN Primary

Addresses

Primary practice location

2450 Riverside Ave
M653 East Building
Minneapolis, MN 55454-1450

Mailing address

2450 Riverside Ave
M653 East Building
Minneapolis, MN 55454-1450
Phone (612) 624-9668

Other identifiers 2

IdentifierTypeStateIssuer
125-052976OtherILILLINOIS LICENSE NUMBER
56404OtherMNMINNESOTA LICENSE NUMBER

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
I20130716000588 MN Practitioner - Pediatric Medicine 9638200322 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Johns Hopkins University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-1313

919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-052976ILMDPediatrics Physician
56404MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Care System CurrentSince Apr 1, 2020 Accepting new patients
Fairview Clinics CurrentSince May 1, 2013 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince May 1, 2013 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Apr 1, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Bethesda Hospital CurrentSince Apr 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Apr 1, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Clinics CurrentSince Apr 1, 2020 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast St. John'S Hospital CurrentSince Apr 1, 2020 Accepting new patients

Locations

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

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

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

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

2450 Riverside Ave
#M653
Minneapolis, MN 55454
Phone (612) 624-9668

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

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

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

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

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

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

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

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

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

Interoperability endpoints

  • Direct secure messaging: mpitt298488@fairview.direct-ci.com

Organizations & group practices 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1104072172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "address_2": "M653 EAST BUILDING",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-624-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "address_2": "M653 EAST BUILDING",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-624-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITT",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-11",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125-052976",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "56404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE NUMBER",
            "identifier": "125-052976",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA LICENSE NUMBER",
            "identifier": "56404",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.