Minnesota Lung Center LTD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

MINNESOTA LUNG CENTER LTD

Practice address

920 E 28TH St
Suite 700
Minneapolis, MN 55407-1139

Phone

(952) 567-7400

Fax

(952) 567-7414

NPI assigned

Jul 5, 2006

Last updated

Feb 26, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Deb Mayer

Title

Business Office MGR.

Phone

(952) 567-7400

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Northstar Sleep Center LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Coon Rapids, MN
  • NPI 1124315700

  Member Of

  NPD member

Locations

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joan MK Fox, M.D.

  • Pulmonary Disease Physician
  • Minneapolis, MN
  • NPI 1679593925
  Medicare reassignment NPD
• Kevin Rene Grullon, M.D.

  • Pulmonary Disease Physician
  • Minneapolis, MN
  • NPI 1295976645
  Medicare reassignment NPD
• Jonathan T Hovda, MD, MBA

  • Pulmonary Disease Physician
  • Minneapolis, MN
  • NPI 1689836942
  Medicare reassignment NPD
• Mitchell G Kaye, M.D.

  • Pulmonary Disease Physician
  • Minneapolis, MN
  • NPI 1760402010
  Medicare reassignment NPD
• Erin Elizabeth Peterson, RN, NP-C

  • Nurse Practitioner
  • St Louis Park, MN
  • NPI 1447560305
  Medicare reassignment NPD
• Kelsey Therese Sharma, APRN, CNP

  • Family Nurse Practitioner
  • Minneapolis, MN
  • NPI 1932761020
  Medicare reassignment NPD
• Patrick J Wright, M.D.

  • Pulmonary Disease Physician
  • Minneapolis, MN
  • NPI 1811917164
  Medicare reassignment NPD
• Tonia R. Ashline, PA-C

  • Physician Assistant
  • Edina, MN
  • NPI 1992734032
  Medicare reassignment
• Sarah Anne Bolstad, PAC

  • Medical Physician Assistant
  • Minneapolis, MN
  • NPI 1558323352
  Medicare reassignment
• Jane Breeggemann, PA-C

  • Physician Assistant
  • Minneapolis, MN
  • NPI 1487225884
  Medicare reassignment
• Gina Sejin Dahlin, PA-C

  • Physician Assistant
  • Saint Paul, MN
  • NPI 1235109356
  Medicare reassignment
• Kathy R Gromer, M.D.

  • Pulmonary Disease Physician
  • Minneapolis, MN
  • NPI 1336166149
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1184655813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E 28TH ST",
            "address_2": "SUITE 700",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071139",
            "telephone_number": "952-567-7400",
            "fax_number": "952-567-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E 28TH ST",
            "address_2": "SUITE 700",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071139",
            "telephone_number": "952-567-7400",
            "fax_number": "952-567-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA LUNG CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "DEB",
        "authorized_official_title_or_position": "BUSINESS OFFICE MGR.",
        "authorized_official_telephone_number": "952-567-7400"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410210000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CP2438",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Minnesota Low Vision Store, Inc.
• Minnesota Medication Repository Program (RoundtableRx)
• Minnesota Neurovascular & Skull Base Surgery
• Minnesota Oncology Hematology, PA
• Minnesota Orthopaedic Specialists, P.a.
• Minnesota Orthopedic Performance and Prevention LLC

• Pulmonary Disease Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pulmonary Disease Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.