Individual provider Active NPI

Mark Patrick Kerekes, MD

  • Child & Adolescent Psychiatry Physician
  • Eagan, MN
National Provider Identifier
1215033238
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
39355 Issued in MN
Practice address
1185 Town Centre Dr
Suite 225 Bhsi LLC
Eagan, MN 55123-1186
Phone
(651) 769-6200
Fax
(651) 769-6249
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 39355 MN Primary

Addresses

Primary practice location

1185 Town Centre Dr
Suite 225 Bhsi LLC
Eagan, MN 55123-1186

Mailing address

2497 7TH Ave E
Suite 101 Bhsi LLC
North St Paul, MN 55109-2496
Phone (651) 769-6200

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
I20040805000858 MN Practitioner - Psychiatry 2668443250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Nebraska College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bhsi LLCGroup PAC ID 3274504816, 33 clinicians

Practice addresses (Care Compare)

2497 7TH Ave E
Suite 101
North St Paul, MN 55109-2946
Phone (651) 769-6400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39355MNMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bhsi, LLC CurrentSince Sep 10, 2010 Accepting new patients

Locations

1185 Town Centre Dr
Ste 225
Eagan, MN 55123
Phone (651) 681-1600

2497 7th Ave E
Ste 101
Saint Paul, MN 55109
Phone (651) 769-6400

2497 7th Ave E
Saint Paul, MN 55109
Phone (651) 387-2165

Organizations & group practices 1

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215033238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2497 7TH AVE E",
            "address_2": "SUITE 101 BHSI LLC",
            "city": "NORTH ST PAUL",
            "state": "MN",
            "postal_code": "551092496",
            "telephone_number": "651-769-6200",
            "fax_number": "651-769-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 TOWN CENTRE DR",
            "address_2": "SUITE 225 BHSI LLC",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231186",
            "telephone_number": "651-769-6200",
            "fax_number": "651-769-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEREKES",
        "first_name": "MARK",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MN",
            "license": "39355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.