Active NPI
Cody M Bakken, PA-C
- Medical Physician Assistant
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 13107
- Practice address
- 701 Park Ave
Minneapolis, MN 55415-1623 - Phone
- (612) 873-3000
- NPI assigned
- Dec 2, 2018
- Last updated
- Apr 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Medical Physician Assistant | 363AM0700X | 13107 | MN | Primary |
Addresses
Primary practice location
701 Park Ave
Minneapolis, MN 55415-1623
Mailing address
701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1700 University Ave W
Saint Paul, MN 55104-3727
6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000
911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-1313
919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.44 of 100
- Quality
- 82.65
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.21
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.67 of 100
- Quality
- 74.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.86
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13107 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients |
Locations
14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400
2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740
Interoperability endpoints
- cbakken901663@fairview.direct-ci.com
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
dba M Health Fairview Recovery Clinic
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- Clinic/Center
- Saint Paul, MN
- NPI 1275277204
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
dba Fairview Emergency Medical Services
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Fairview Hospital University
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
dba Fairview Southdale Hospital
- General Acute Care Hospital
- Edina, MN
- NPI 1699752915
-
dba Fairview Diagnostic Laboratory
- General Acute Care Hospital
- Edina, MN
- NPI 1932260833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680825600000",
"number": "1144790270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 PARK AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151623",
"telephone_number": "612-873-6963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 PARK AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151623",
"telephone_number": "612-873-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKKEN",
"first_name": "CODY",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-02",
"last_updated": "2023-04-07",
"certification_date": "2023-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MN",
"license": "13107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.