Individual provider Active NPI

Henri Roukoz, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Minneapolis, MN
National Provider Identifier
1144499187
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
23999 Issued in MN
Practice address
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone
(612) 672-7422
NPI assigned
Feb 25, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.009909 OH
Cardiovascular Disease Physician 207RC0000X 21226 MN
Clinical Cardiac Electrophysiology Physician 207RC0001X 23999 MN Primary

Addresses

Primary practice location

909 Fulton St SE
Minneapolis, MN 55455-4800

Mailing address

420 Delaware St SE
Mmc508
Minneapolis, MN 55455-0341
Phone (612) 625-4401

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
I20130729000216 MN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac ElectrophysiologyPractitioner - Plastic and Reconstructive Surgery 9931340353 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians

Practice addresses (Care Compare)

10000 Zane Ave N
Brooklyn Park, MN 55443-1400
Phone (763) 572-5700

10961 Club W Pkwy NE
Blaine, MN 55449-4671
Phone (763) 572-5700

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Phone (218) 326-3401

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (855) 324-7843

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

2020 E 28TH St
Minneapolis, MN 55407-1394
Phone (612) 672-7422

2450 Riverside Ave
Minneapolis, MN 55454-1450

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

6320 Wedgwood Rd N
Maple Grove, MN 55311-3647
Phone (763) 268-0400

6341 University Ave NE
Fridley, MN 55432-4946
Phone (763) 572-5700

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

6401 University Ave NE
Fridley, MN 55432-4341
Phone (763) 502-6602

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.009909OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Mar 22, 2016 Accepting new patients
Fairview Health Services Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Mar 22, 2016 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Apr 27, 2020 Accepting new patients
Fairview Bethesda Hospital CurrentSince Apr 27, 2020 Accepting new patients
Fairview Health Services CurrentSince Jul 12, 2013 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Nov 11, 2019 Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Apr 27, 2020 Accepting new patients
Fairview Clinics CurrentSince Apr 27, 2020 Accepting new patients
Healtheast St. John's Hospital CurrentSince Apr 27, 2020 Accepting new patients
Healtheast Medical Research Institute Internal Medicine CurrentSince Apr 27, 2020 Accepting new patients
Healtheast Care System CurrentSince Apr 27, 2020 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Nov 11, 2019 Accepting new patients
Range Regional Health Services CurrentSince Sep 2, 2023 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Health Services CurrentSince Jul 12, 2013 Accepting new patients
Range Regional Health Services CurrentSince Sep 2, 2023 Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 27, 2020 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Cardiothoracic Surgery Clinic of North Ms Past Accepting new patients
Fairview Express Care Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

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

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

3605 Mayfair Ave
Hibbing, MN 55746
Phone (218) 262-3441

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

10000 Zane Ave N
Minneapolis, MN 55443
Phone (763) 528-6999

10961 Club West Pkwy
Minneapolis, MN 55449
Phone (763) 572-5700

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

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

420 Delaware St SE
#508
Minneapolis, MN 55455
Phone (612) 625-4401

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980

6405 France Ave S
Ste W200
Minneapolis, MN 55435
Phone (952) 836-3700

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

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

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

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

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

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

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

Interoperability endpoints

  • Direct secure messaging: hroukoz92539@fairview.direct-ci.com

Organizations & group practices 25

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 25

Hospital & facility affiliations 8

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": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144499187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC508",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-625-4401",
            "fax_number": "612-626-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800",
            "telephone_number": "612-672-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUKOZ",
        "first_name": "HENRI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.009909",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "21226",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MN",
            "license": "23999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.