NPIMap

Individual provider Active NPI

Sou-Pan Wu, MD

  • Rheumatology Physician
  • Woodbury, MN
National Provider Identifier
1114993961
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
48087 Issued in MN
Practice address
4040 Radio Dr
Woodbury, MN 55129-3237
Phone
(651) 439-8807
Fax
(651) 439-0232
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 42668 WI
Rheumatology Physician 207RR0500X 48087 MN Primary

Addresses

Primary practice location

4040 Radio Dr
Woodbury, MN 55129-3237

Mailing address

4200 Dahlberg Dr Ste 300
Golden Valley, MN 55422-4841
Phone (952) 512-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050728000378 MN Practitioner - RheumatologyPractitioner - Internal Medicine 9931137213 Reassigns benefits to 2 organizations
I20180905003853 WI Practitioner - RheumatologyPractitioner - Internal Medicine 9931137213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

2651 Hillcrest Dr
Suite 101
Hudson, WI 54016-9919
Phone (800) 423-1088

4040 Radio Dr
Woodbury, MN 55129-3237
Phone (651) 439-8807

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48087MNMDRheumatology Physician
42668WIMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Jul 1, 2023 Accepting new patients
Infinite Health Collaborative, PA Rheumatology CurrentSince Jul 1, 2023 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Aug 30, 2018 Accepting new patients
Group Health, Inc. CurrentSince Jul 1, 2005 Accepting new patients
Group Health, Inc. CurrentSince Jul 1, 2005 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

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

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

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

401 Phalen Blvd
Stop 41103E
Saint Paul, MN 55130

401 Phalen Blvd
#41103A
Saint Paul, MN 55130
Phone (651) 254-7800

5715 Memorial Ave N
Stillwater, MN 55082
Phone (514) 398-8076

4040 Radio Dr
Woodbury, MN 55129
Phone (514) 398-8076

2211 Vine St
Hudson, WI 54016
Phone (715) 386-1155

2651 Hillcrest Dr
Ste 101
Hudson, WI 54016
Phone (800) 423-1088

744 E Louisiana St
St Croix Fls, WI 54024
Phone (651) 772-6251

Interoperability endpoints

  • Direct secure messaging: swu34588@direct.healthpartners.com

Organizations & group practices 8

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1114993961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR STE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224841",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 RADIO DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551293237",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "SOU-PAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WI",
            "license": "42668",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MN",
            "license": "48087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.