NPIMap

Individual provider Active NPI

Mark G Macdonald, MD

  • Family Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1124080791
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40313 Issued in MN
Practice address
1700 University Ave W FL 1
Saint Paul, MN 55104-3727
Phone
(651) 232-2002
Fax
(651) 232-2031
NPI assigned
Apr 6, 2006
Last updated
Oct 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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 40313 MN Primary

Addresses

Primary practice location

1700 University Ave W FL 1
Saint Paul, MN 55104-3727

Mailing address

1690 University Ave W
Suite 460
Saint Paul, MN 55104-3723
Phone (651) 232-2002

Other identifiers 1

IdentifierTypeStateIssuer
848182200MedicaidMN

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
I20040708001463 MN Practitioner - Family Practice 6305824129 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeris Medical Group PLLCGroup PAC ID 0042624306, 26 clinicians

Practice addresses (Care Compare)

St Louis Park, MN 55416
Phone (914) 589-5503

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40313MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
Aeris Medical Group PLLC CurrentSince Jan 1, 2023 Accepting new patients
Fairview Clinics CurrentSince Jan 1, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Jan 1, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 1, 2004 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 1, 2004 Accepting new patients
Estates at Excelsior LLC Past Accepting new patients
Villas at Brookview LLC Past Accepting new patients
The Emeralds at Grand Rapids LLC Past Accepting new patients
Healtheast St. John's Hospital Past Accepting new patients
Villas at the Cedars LLC Past Accepting new patients
The Waterview Woods LLC Past Accepting new patients
Villas at St. Louis Park LLC Past Accepting new patients
Estates at St Louis Park LLC Past Accepting new patients
Estates at Rush City LLC Past Accepting new patients
Estates at Fridley LLC Past Accepting new patients
The Waterview Pines LLC Past Accepting new patients

Locations

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097

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

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

800 2nd Ave NW
Plainview, MN 55964
Phone (507) 534-3191

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

1690 University Ave W
Ste 460
Saint Paul, MN 55104
Phone (651) 232-2002

17 Exchange St W
Ste 835
Saint Paul, MN 55102
Phone (651) 232-4200

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1983 Sloan Pl
Ste 1
Saint Paul, MN 55117
Phone (651) 326-5700

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

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

724 19th Ave N
South St Paul, MN 55075
Phone (651) 232-6000

1201 8th St S
Virginia, MN 55792
Phone (218) 741-7800

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

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

Organizations & group practices 19

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 19

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1124080791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 UNIVERSITY AVE W",
            "address_2": "SUITE 460",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043723",
            "telephone_number": "651-232-2002",
            "fax_number": "651-232-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W FL 1",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "651-232-2002",
            "fax_number": "651-232-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "MARK",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "40313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "848182200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.