Individual provider Active NPI

Marcus Fearing

  • Sports Medicine (Family Medicine) Physician
  • Saint Paul, MN
National Provider Identifier
1154984904
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
75119 Issued in MN
Practice address
435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone
(952) 831-8742
NPI assigned
Apr 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 82695-20 WI
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Family Medicine) Physician 207QS0010X 75119 MN Primary

Addresses

Primary practice location

435 Phalen Blvd
Saint Paul, MN 55130-5302

Mailing address

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

Other practice location 1

3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone (913) 588-1902

Other practice location 2

155 Radio Dr
Woodbury, MN 55125-2619
Phone (952) 831-8742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230921001388 WI Practitioner - Sports Medicine 8022344688 Reassigns benefits to 3 organizations
I20230921001767 MN Practitioner - Sports Medicine 8022344688 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Creighton University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

403 Stageline Rd
Hudson, WI 54016-7848
Phone (952) 831-8742

405 Stageline Rd
Hudson, WI 54016-7848
Phone (952) 831-8742

411 Stageline Rd
Hudson, WI 54016-7848
Phone (952) 831-8742

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75119MNMDSports Medicine (Family Medicine) Physician
82695-20WIMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Westfields Hospital, Inc CurrentSince Sep 11, 2023 Accepting new patients
Group Health, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Sep 11, 2023 Accepting new patients
Westfields Hospital, Inc. CurrentSince Sep 11, 2023 Accepting new patients

Locations

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

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

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

435 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200

155 Radio Dr
Woodbury, MN 55125
Phone (952) 883-6212

411 Stageline Rd
Ste 100
Hudson, WI 54016

411 Stageline Rd
Ste 150
Hudson, WI 54016
Phone (715) 531-6700

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1154984904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 PHALEN BLVD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551305302",
            "telephone_number": "952-831-8742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Rainbow Blvd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661608500",
            "country_code": "US",
            "telephone_number": "913-588-1902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 Radio Dr",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551252619",
            "country_code": "US",
            "telephone_number": "952-831-8742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEARING",
        "first_name": "MARCUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "82695-20",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MN",
            "license": "75119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.