Individual provider Active NPI

Gary Robert Kravitz, MD

  • Infectious Disease Physician
  • St Paul, MN
National Provider Identifier
1124085840
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
24327 Issued in MN
Practice address
1959 Sloan PL
Ste 200
St Paul, MN 55117-2074
Phone
(651) 772-6235
Fax
(651) 772-6261
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 24327 MN
Infectious Disease Physician 207RI0200X 24327 MN Primary

Addresses

Primary practice location

1959 Sloan PL
Ste 200
St Paul, MN 55117-2074

Mailing address

1959 Sloan PL
Ste 200
St Paul, MN 55117-2074
Phone (651) 772-6235

Other identifiers 1

IdentifierTypeStateIssuer
899307600MedicaidMN

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
I20050802000123 MN Practitioner - Infectious Disease 3072507847 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute Internal Medicine CurrentSince Nov 1, 2011 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Fairview Health Services Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
St. Paul Infectious Disease Associates, LTD. Infectious Disease Current Accepting new patients
Fairview Health Services CurrentSince Aug 15, 2018 Accepting new patients
Fairview Clinics CurrentSince Aug 15, 2018 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

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

1959 Sloan Pl
Ste 200
Saint Paul, MN 55117
Phone (651) 772-6235

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

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1124085840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 SLOAN PL",
            "address_2": "STE 200",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551172074",
            "telephone_number": "651-772-6235",
            "fax_number": "651-772-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 SLOAN PL",
            "address_2": "STE 200",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551172074",
            "telephone_number": "651-772-6235",
            "fax_number": "651-772-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVITZ",
        "first_name": "GARY",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "24327",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MN",
            "license": "24327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899307600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Paul, MN

Sources for this page

Verify at the official NPI Registry.