Universal Medical Services Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

UNIVERSAL MEDICAL SERVICES INC

Practice address

1801 Nicollet Ave S
Suite 101
Minneapolis, MN 55403-3745

Phone

(612) 823-2947

Fax

(612) 870-2947

NPI assigned

Sep 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Crispin J Semakula, M.D

Title

Board Chairman

Phone

(612) 823-2947

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• AXIS Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

Enrollment records 2

Federally qualified health center certification: CCN 241864

Legal name

UNIVERSAL MEDICAL SERVICES, INC

Doing business as

AXIS MEDICAL CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 14, 2010

Last certification

Oct 14, 2010

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Apr 10, 2008 in MN

Enrollment address

1801 Nicollet Ave
Ste 101
Minneapolis, MN 55403-3791

Federally qualified health center certification: CCN 241887

Legal name

UNIVERSAL MEDICAL SERVICES, INC

Doing business as

AXIS MEDICAL CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 2, 2019

Last certification

Oct 2, 2019

Ownership / control type

For profit – corporation

Organization structure

OtherNon-profit

Enrollment address

1 W Lake St
Minneapolis, MN 55408-3154

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Universal Medical Services Inc

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1396395752

  9032283262

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Universal Medical Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1538726393

  O20190919000883

  Same enrollment

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JGEABA

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Crispin Semakula, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Minneapolis, MN
  • NPI 1538107214

  Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1124214630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 NICOLLET AVE S",
            "address_2": "SUITE 101",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033745",
            "telephone_number": "612-823-2947",
            "fax_number": "612-870-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NICOLLET AVE S",
            "address_2": "SUITE 101",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033745",
            "telephone_number": "612-823-2947",
            "fax_number": "612-870-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL MEDICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "SEMAKULA",
        "authorized_official_first_name": "CRISPIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BOARD CHAIRMAN",
        "authorized_official_telephone_number": "612-823-2947",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5671767000(MHCP)",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AXIS Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Universal Home Health Care Agency Corp
• Universal Language Network
• Universal Medical Services Inc
• Universal Medical Services Inc
• Universal Medical Services Inc
• Universal Medical Services, Inc
• Universal Medical Services, Inc Dbaaxis Medical Center

• Federally Qualified Health Center (FQHC) in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Federally Qualified Health Center (FQHC) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.