Minnesota Neurovascular & Skull Base Surgery

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

MINNESOTA NEUROVASCULAR & SKULL BASE SURGERY

Practice address

3033 Excelsior Blvd
Suite 403
Minneapolis, MN 55416-4688

Phone

(612) 374-0177

Fax

(612) 374-0893

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Eric S Nussbaum, MD

Title

Owner

Phone

(612) 374-0177

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew D Danilson, PA- C

  • Surgical Physician Assistant
  • Fort Dodge, IA
  • NPI 1669669628
  NPD (past)
• Kevin Lee Stevenson, MD

  • Neurological Surgery Physician
  • Macon, GA
  • NPI 1821042946
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1215059878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 W 25TH ST",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554163803",
            "telephone_number": "952-285-1016",
            "fax_number": "952-285-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD",
            "address_2": "SUITE 403",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164688",
            "telephone_number": "612-374-0177",
            "fax_number": "612-374-0893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA NEUROVASCULAR & SKULL BASE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "NUSSBAUM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-374-0177",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77007040",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21266300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minnesota Internship Center Charter School
• Minnesota Interpreters and Translators (Mint)
• Minnesota Low Vision Store, Inc.
• Minnesota Lung Center LTD
• Minnesota Medication Repository Program (RoundtableRx)
• Minnesota Oncology Hematology, PA
• Minnesota Orthopaedic Specialists, P.a.
• Minnesota Orthopedic Performance and Prevention LLC
• Minnesota Pain Prevention Clinic, P.a.
• Minnesota Pca Home Healthy Care LLC

• Neurological Surgery Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Neurological Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.