Active NPI
Anne G Minenko, MD
- Rheumatology Physician
- Minneapolis, MN
National Provider Identifier
1215037080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 42698
- Practice address
- 516 Delaware St SE
PWB Sixth Floor, Clinic 6a
Minneapolis, MN 55455-0356 - Phone
- (612) 625-8690
- NPI assigned
- Sep 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 42698 | MN | Primary |
| Internal Medicine Physician | 207R00000X | 42698 | MN |
Addresses
Primary practice location
516 Delaware St SE
PWB Sixth Floor, Clinic 6a
Minneapolis, MN 55455-0356
Mailing address
420 Delaware Street SE, MMC 108
University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 625-8690
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010905300 | Medicaid | MN | |
| 1023931 | Other | MN | PREFERRED ONE |
| HP31270 | Other | MN | HEALTH PARTNERS |
| 1031133 | Other | MN | ARAZ |
| 34012200 | Medicaid | WI | |
| 127830 | Other | MN | UCARE |
| 32-00003 | Other | MN | MEDICA PRIMARY |
| 1031133 | Other | ARAZ | |
| 77R66MI | Other | MN | BLUE CROSS BLUE SHIELD |
| 32-00055 | Other | MN | MEDICA CHOICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Minnesota Physicians | Past | Accepting new patients |
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185840000000",
"number": "1215037080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 DELAWARE STREET SE, MMC 108",
"address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55455",
"telephone_number": "612-625-8690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 DELAWARE ST SE",
"address_2": "PWB SIXTH FLOOR, CLINIC 6A",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550356",
"telephone_number": "612-625-8690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINENKO",
"first_name": "ANNE",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-22",
"last_updated": "2007-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "MN",
"license": "42698",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "42698",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010905300",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1023931",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP31270",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "1031133",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34012200",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "127830",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA PRIMARY",
"identifier": "32-00003",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "1031133",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "77R66MI",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA CHOICE",
"identifier": "32-00055",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.