Individual provider Active NPI

Audra L Mintz, DPM

  • Foot & Ankle Surgery Podiatrist
  • Anoka, MN
National Provider Identifier
1124215132
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
832 Issued in MN
Practice address
601 Jacob LN
Anoka, MN 55303-1776
Phone
(763) 587-4200
Fax
(763) 587-4205
NPI assigned
Oct 3, 2007
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 832 MN Primary

Addresses

Primary practice location

601 Jacob LN
Anoka, MN 55303-1776

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110413000946 MN Practitioner - Podiatry 3779767819 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

15800 95TH Ave N
Maple Grove, MN 55369-4400
Phone (952) 993-1440

2621 Greenhaven Rd
Anoka, MN 55303-1776
Phone (952) 853-8800

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (612) 427-2200

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue20
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
832MNMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Dec 22, 2010 Accepting new patients
Group Health, Inc. Current Accepting new patients

Locations

2621 Greenhaven Rd
Anoka, MN 55303
Phone (763) 587-4400

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

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

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

Interoperability endpoints

  • Direct secure messaging: amintz41149@direct.healthpartners.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1124215132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JACOB LN",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553031776",
            "telephone_number": "763-587-4200",
            "fax_number": "763-587-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTZ",
        "first_name": "AUDRA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MN",
            "license": "832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anoka, MN

Sources for this page

Verify at the official NPI Registry.