NPIMap

Individual provider Active NPI

Steve S. Tekippe, M.D.

  • Family Medicine Physician
  • Moose Lake, MN
National Provider Identifier
1194728733
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36731 Issued in MN
Practice address
4570 Cty. Hwy. 61
Moose Lake, MN 55767
Phone
(218) 485-4491
Fax
(218) 485-4724
NPI assigned
May 27, 2005
Last updated
Dec 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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 36731 MN Primary

Addresses

Primary practice location

4570 Cty. Hwy. 61
Moose Lake, MN 55767

Mailing address

4570 Cty. Hwy. 61
Moose Lake, MN 55767
Phone (218) 485-4491

Other identifiers 1

IdentifierTypeStateIssuer
056723000MedicaidMN

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
I20090519000522 MN Practitioner - Family Practice 4385556661 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4570 Cty Hwy 61
Moose Lake, MN 55767-9401
Phone (218) 485-4491

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy14
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Family Health Clinic, LTD. Family Medicine CurrentSince Oct 16, 1995 Accepting new patients
Gateway Family Health Clinic, LTD. Current Accepting new patients
Essentia Health Moose Lake Past Accepting new patients
Gateway Family Health Clinic, LTD. Family Medicine Past Accepting new patients

Locations

716 S Kenwood Ave
Moose Lake, MN 55767
Phone (218) 485-4491

707 Lundorff Dr
#1
Sandstone, MN 55072
Phone (320) 245-2250

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDGJBA
  • Direct secure messaging: steven.tekippe@gfhc.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gateway Family Health Clinic, LTD.Sandstone, MN, CCN 243859 Rural health clinic 5% Or Greater Direct Ownership Interest (9.09%)
General Partnership Interest (9.09%)
Corporate Director
W-2 Managing Employee (9.09%)		 Jan 1, 1997
Jan 1, 1997
Sep 1, 1995
Jan 1, 1997

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1194728733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 CTY. HWY. 61",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "55767",
            "telephone_number": "218-485-4491",
            "fax_number": "218-485-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 CTY. HWY. 61",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "55767",
            "telephone_number": "218-485-4491",
            "fax_number": "218-485-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKIPPE",
        "first_name": "STEVE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "36731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056723000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moose Lake, MN

Sources for this page

Verify at the official NPI Registry.