NPIMap

Individual provider Active NPI

Edward Thomas Schaefer, D.O.

  • Gastroenterology Physician
  • Saint Paul, MN
National Provider Identifier
1114369279
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
65223 Issued in MN
Practice address
435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone
(651) 254-8680
Fax
(651) 254-8656
NPI assigned
Jul 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Q8630 TX
Gastroenterology Physician 207RG0100X 65223 MN Primary
Internal Medicine Physician 207R00000X 65223 MN

Addresses

Primary practice location

435 Phalen Blvd
Saint Paul, MN 55130-5302

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516

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
I20190718003150 MN Practitioner - Internal Medicine 0749583698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

15800 95TH Ave N
Maple Grove, MN 55369-4400
Phone (952) 993-1440

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053
  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy91
Upper gastrointestinal (GI) endoscopy for acid reflux50

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q8630TXMDInternal Medicine Physician
65223MNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Aug 5, 2019 Accepting new patients
Park Nicollet Clinic CurrentSince Sep 30, 2025 Accepting new patients
Group Health, Inc. Current Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Group Health, Inc. CurrentSince Aug 5, 2019 Accepting new patients
Park Nicollet Clinic CurrentSince Sep 30, 2025 Accepting new patients

Locations

2621 Greenhaven Rd
Anoka, MN 55303
Phone (763) 587-4400

14000 Fairview Dr
Burnsville, MN 55337
Phone (952) 993-8608

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

435 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

435 Phalen Blvd
#51103B
Saint Paul, MN 55130
Phone (651) 254-8600

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

Organizations & group practices 6

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1114369279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 PHALEN BLVD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551305302",
            "telephone_number": "651-254-8680",
            "fax_number": "651-254-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "EDWARD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-17",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q8630",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "65223",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "65223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.