Michael John Garvis, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

39775 Issued in MN

Practice address

17705 Hutchins Dr
Minnetonka, MN 55345-4102

Phone

(952) 401-8300

NPI assigned

Feb 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Pediatric Medicine

Education

Sanford School of Medicine of University of South Dakota, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Lake Clinic PAGroup PAC ID 3173500303, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• South Lake Clinic, P.a.

  • Pediatrics Physician
  • Minnetonka, MN
  • NPI 1427027184
  Medicare reassignment Care Compare group NPD
• Urgent Care Doctors Office, PA

  • Family Medicine Physician
  • Eden Prairie, MN
  • NPI 1447204433

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1235101130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17705 HUTCHINS DR STE 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454102",
            "telephone_number": "952-401-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17705 HUTCHINS DR",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454102",
            "telephone_number": "952-401-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARVIS",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "39775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFFERED ONE",
            "identifier": "CP9041014230",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1200254",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "120172",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "30B12GA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicollette Gardner
• Shawn M Gardner, MYOTHERAPIST
• Susan B. Garfield, LISCW, ACSW
• Jill Marie Garnier, MD
• Tiffany Nicole Garrigan, M.P.T.
• Gary L. Carlson, D.D.S., P.a.
• Kimberly Gascoigne
• Nicole M Gase, NP
• Leng Gauv, CRNP, FNP-C
• Kathryn Amelia Gehrig, MD

• Pediatrics Physician in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.