Annalisa Kay Eckman Rudser, MD
Individual provider Active NPI Pediatrics Physician · Minneapolis, MN
NPI 1215062062 · NPPES record last updated Jun 25, 2013
Key facts
- NPI
- 1215062062
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 19502 (MN)
- Practice address
- 2525 Chicago Ave
Minneapolis, MN 55404-4518 - Phone
- (612) 813-6000
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150519001407 | MN | Practitioner - Emergency Medicine |
5193045904 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19502 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Care Consultants, PA | Current |
Accepting new patients | |
| Allina Health System | Current |
Accepting new patients | |
| Allina Health System | Current |
Accepting new patients | |
| Childrens Health Care | Current |
Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Childrens Health Care | Current |
Accepting new patients | |
| Childrens Health Care | Pediatrics | Current | Accepting new patients |
| Ecc Addiction & Toxicology Services LLC | Past | Accepting new patients |
Locations
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547
2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000
5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691
347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 19502 | MN | Yes |
Addresses
Primary practice location
2525 Chicago Ave
Minneapolis, MN 55404-4518
Mailing address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Other providers in Minneapolis, MN
- Michael Andrew Rudder
- Brittany Ruden
- Kathleen Rudh
- Joseph W. Rudolf
- Steven Eric Rudolph
- Alek Rudstrom
- Alison C Rudy
- Isaac B Rue
- Jessica Ruedy
- Anna Ruehlow
All providers in Minneapolis, MN · Pediatrics Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.