Michael H Bambenek, M.D.
Individual provider Active NPI Emergency Medicine Physician · Maplewood, MN
NPI 1215323787 · NPPES record last updated Apr 28, 2020
Key facts
- NPI
- 1215323787
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 63714 (MN)
- Practice address
- 1575 Beam Ave
Maplewood, MN 55109-1126 - Phone
- (651) 232-7348
- Fax
- (612) 439-1860
- NPI assigned
- Apr 12, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- University of Minnesota Medical School, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Emergency Care Consultants PA
Practice addresses (Care Compare)
45 10TH St W
Saint Paul, MN 55102-1062
Phone (651) 232-3000
Hospital & facility affiliations
- M Health Fairview St John'S Hospital
- M Health Fairview Woodwinds Hospital
- Owatonna Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 95.56
- Promoting interoperability
- 100
- Improvement activities
- 40
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 |
|---|---|---|---|---|
| I20180613003478 | MN | Practitioner - Emergency Medicine | 1759683832 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63714 | MN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Health Services | Current | Accepting new patients | |
| Emergency Care Consultants, PA | Emergency Medicine | Current |
Accepting new patients |
| Ecc Addiction & Toxicology Services LLC | Current |
Accepting new patients | |
| Fairview Health Services | Emergency Medicine | Current |
Accepting new patients |
| Fairview Health Services | Current |
Accepting new patients |
Locations
1175 Nininger Rd
Hastings, MN 55033
Phone (651) 404-1000
2829 University Ave SE
Ste 730
Minneapolis, MN 55414
Phone (612) 439-1868
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838
800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547
2250 NW 26th St
Owatonna, MN 55060
Phone (507) 451-3850
2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256
45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000
1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000
1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 63714 | MN | Yes |
Addresses
Primary practice location
1575 Beam Ave
Maplewood, MN 55109-1126
Mailing address
2829 University Ave SE Ste 730
Minneapolis, MN 55414-3279
Phone (612) 439-1868
Other providers in Maplewood, MN
- Ann Marie Baker
- Keith Bakke
- Balsam Home Care Inc
- Maria Denise Balsimo
- Jessica R Baltz
- Lynda K Bangtson
- Anna Rae Barlow
- Tiana M Barsness
- Bartlett Family Chiropractic LLC
- Aaron Michael Bartlett
All providers in Maplewood, MN · Emergency Medicine 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 Apr 28, 2020. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.