Individual provider Active NPI

Matthew Mesnik, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Blaine, MN
National Provider Identifier
1124060272
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
29871 Issued in MN
Practice address
10190 Baltimore St NE
Blaine, MN 55449-5056
Phone
(763) 795-9363
Fax
(796) 379-5936
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 29871 MN Primary

Addresses

Primary practice location

10190 Baltimore St NE
Blaine, MN 55449-5056

Mailing address

2340 Brookridge Ave
Golden Valley, MN 55422-3304
Phone (763) 541-5337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221017003270 MN Practitioner - General Practice 8729072921
I20221028000770 ND Practitioner - General Practice 8729072921 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29871MNMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rvision Health of North Dakota PC CurrentSince May 22, 2022 Accepting new patients

Locations

6701 Evenstad Dr N
Ste 100
Maple Grove, MN 55369
Phone (763) 513-4300

706 38th St N
Ste A
Fargo, ND 58102
Phone (701) 893-4557

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124060272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 BROOKRIDGE AVE",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554223304",
            "telephone_number": "763-541-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10190 BALTIMORE ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495056",
            "telephone_number": "763-795-9363",
            "fax_number": "796-379-5936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESNIK",
        "first_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MN",
            "license": "29871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.