Individual provider Active NPI

Marla Annette Dewitt, M.D.

  • Family Medicine Physician
  • Rochester, MN
National Provider Identifier
1164640918
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51340 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905
Phone
(507) 284-2511
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 51340 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

927 Trettel Lane
Cloquet, MN 55720
Phone (651) 438-1800

Other practice location 2

927 Trettel Lane
Cloquet, MN 55720
Phone (651) 438-1800

Other names 1

  • Ms. Marla Annette Dewitt Tesch Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdewitttesch132980@ehrdirect.mayoclinicmsg.org

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
I20090903000470 MN Practitioner - Family Practice 3072668680 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mayo Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Hospital & facility affiliations

  • Mayo Clinic Health System in Red Wing Hospital, Red Wing, MN, CCN 240018
  • Mayo Clinic Hospital Rochester Hospital, Rochester, MN, CCN 240010

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51340MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fond Du Lac Reservation Business Committee CurrentSince Nov 25, 2013 Accepting new patients
Mayo Clinic CurrentSince Dec 12, 2016 Accepting new patients
Mayo Clinic CurrentSince Dec 12, 2016 Accepting new patients
Fond Du Lac Reservation Business Committee CurrentSince Nov 25, 2013 Accepting new patients
Mayo Clinic Current Accepting new patients
Mayo Clinic Past Accepting new patients
Mayo Clinic Hospital-Rochester Past Accepting new patients

Locations

927 Trettel Ln
Cloquet, MN 55720
Phone (218) 879-1227

211 W 4th St
Duluth, MN 55806
Phone (218) 726-1370

411 W Main St
Kasson, MN 55944
Phone (507) 634-4744

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: marla.dewitt.p1@direct.fonddulachsd.nextgenshare.com

Organizations & group practices 7

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 2

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1164640918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55905",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 Trettel Lane",
            "address_purpose": "LOCATION",
            "city": "Cloquet",
            "state": "MN",
            "postal_code": "55720",
            "country_code": "US",
            "telephone_number": "651-438-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "927 Trettel Lane",
            "address_purpose": "LOCATION",
            "city": "Cloquet",
            "state": "MN",
            "postal_code": "55720",
            "country_code": "US",
            "telephone_number": "651-438-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "MARLA",
        "middle_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "51340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdewitttesch132980@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARLA",
            "last_name": "DEWITT TESCH",
            "middle_name": "ANNETTE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.