Individual provider Active NPI

Lora L Truckenbrod, MD

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1205802477
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40184 Issued in MN
Practice address
2155 Ford Pkwy
Saint Paul, MN 55116-1862
Phone
(651) 696-5000
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 40184 MN Primary

Addresses

Primary practice location

2155 Ford Pkwy
Saint Paul, MN 55116-1862

Mailing address

2155 Ford Pkwy
Saint Paul, MN 55116-1862

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
I20040515000122 MN Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4587654181 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Minnesota Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

3305 Central Park Village Dr
Suite 200
Eagan, MN 55121-7707
Phone (651) 406-8860

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
91.74
Promoting interoperability
100
Improvement activities
40
Cost
77.13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince May 8, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Medical Research Institute Internal Medicine CurrentSince Sep 19, 2019 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 19, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Mar 19, 2019 Accepting new patients
Fairview Express Care CurrentSince May 8, 2021 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

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

14500 99th Ave N
Ste 1210
Maple Grove, MN 55369
Phone (763) 898-1778

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

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

3033 Excelsior Blvd
Ste 275
Minneapolis, MN 55416
Phone (612) 827-4751

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

701 25th Ave S
Ste 402
Minneapolis, MN 55454
Phone (612) 672-2900

3809 42nd Ave S
Minneapolis, MN 55406
Phone (612) 407-7213

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

2155 Ford Pkwy
Ste A
Saint Paul, MN 55116
Phone (651) 696-5000

2155 Ford Pkwy
Saint Paul, MN 55116
Phone (651) 696-5000

3305 Central Park Village Dr
Ste 200
Saint Paul, MN 55121
Phone (651) 406-8860

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

1151 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (612) 706-4500

1390 University Ave W
Saint Paul, MN 55104
Phone (651) 232-4800

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: ltruckenbrod5060@fairview.direct-ci.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1205802477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161862",
            "telephone_number": "651-696-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUCKENBROD",
        "first_name": "LORA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "40184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.