NPIMap

Individual provider Active NPI

Marshall A. Mazepa, M.D.

  • Hematology & Oncology Physician
  • Minneapolis, MN
National Provider Identifier
1174569354
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
157749 Issued in NC
Practice address
M Health Center for Bleeding and Clotting Disorders
2512 S 7TH St, Suite 105
Minneapolis, MN 55454
Phone
(612) 273-5005
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 157749 NC Primary

Addresses

Primary practice location

M Health Center for Bleeding and Clotting Disorders
2512 S 7TH St, Suite 105
Minneapolis, MN 55454

Mailing address

University of Minnesota
420 Delaware St SE, Mayo Mail Code 480
Minneapolis, MN 55455
Phone (608) 215-0658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170103001822 MN Practitioner - Hematology/Oncology 2163663519 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Wisconsin School of Medicine, 2006
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

Practice addresses (Care Compare)

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

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
157749NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Jul 15, 2023 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services CurrentSince Nov 27, 2016 Accepting new patients
Fairview Clinics CurrentSince Nov 27, 2016 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Jul 15, 2023 Accepting new patients
Healtheast Medical Research Institute CurrentSince Mar 30, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Mar 30, 2020 Accepting new patients
University of North Carolina at Chapel Hill Past Accepting new patients

Locations

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

909 Fulton St SE
Ste 202
Minneapolis, MN 55455
Phone (612) 273-8383

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

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

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

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

420 Delaware St SE
#480
Minneapolis, MN 55455
Phone (612) 624-0123

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

2512 S 7th St
Ste 105
Minneapolis, MN 55454
Phone (612) 273-5005

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

919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344

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

Interoperability endpoints

  • Direct secure messaging: mmazepa381950@fairview.direct-ci.com

Organizations & group practices 13

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.

View all 13

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1174569354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF MINNESOTA",
            "address_2": "420 DELAWARE ST SE, MAYO MAIL CODE 480",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "608-215-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "M HEALTH CENTER FOR BLEEDING AND CLOTTING DISORDERS",
            "address_2": "2512 S 7TH ST, SUITE 105",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55454",
            "telephone_number": "612-273-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZEPA",
        "first_name": "MARSHALL",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "157749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.