NPIMap

Individual provider Active NPI

Henry M Dvorak, MD

  • Internal Medicine Physician
  • Waconia, MN
National Provider Identifier
1255330247
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
38681 Issued in MN
Practice address
500 S Maple St
Waconia, MN 55387-1752
Phone
(952) 442-2191
Fax
(952) 442-6535
NPI assigned
Jul 20, 2005
Last updated
May 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38681 MN Primary

Addresses

Primary practice location

500 S Maple St
Waconia, MN 55387-1752

Mailing address

500 S Maple St
Waconia, MN 55387-1752
Phone (952) 442-2191

Other identifiers 1

IdentifierTypeStateIssuer
362227400MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060118000473 MN Practitioner - Internal Medicine 9739103698 Reassigns benefits to 5 organizations
I20260512000870 KS Practitioner - Internal Medicine 9739103698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Minnesota Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cuyuna Regional Medical CenterGroup PAC ID 9537146550, shared by 3 NPIs, 133 clinicians

Practice addresses (Care Compare)

1823 College Ave
Manhattan, KS 66502-3381
Phone (785) 776-3322

320 E Main St
Crosby, MN 56441-1645
Phone (218) 546-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Valley Health Center Inc CurrentSince Aug 28, 2025 Accepting new patients
Ridgeview Medical Center Current Accepting new patients
Cuyuna Regional Medical Center CurrentSince Feb 1, 2021 Accepting new patients
Cuyuna Regional Medical Center CurrentSince Feb 1, 2021 Accepting new patients
Ridgeview Medical Center CurrentSince Jan 1, 2000 Accepting new patients
Minnesota Valley Health Center Inc CurrentSince Aug 28, 2025 Accepting new patients
Sibley Medical Center CurrentSince Nov 7, 2016 Accepting new patients
Cuyuna Regional Medical Center Current Accepting new patients
Carlson Chiropractic Health and Healing Inc. PastSince Jun 7, 2018 Accepting new patients
Ridgeview Medical Center Past Accepting new patients

Locations

601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271

320 E Main St
Crosby, MN 56441
Phone (218) 546-7000

621 S 4th St
Le Sueur, MN 56058
Phone (507) 665-3375

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

500 S Maple St
Ofc
Waconia, MN 55387

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1255330247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871752",
            "telephone_number": "952-442-2191",
            "fax_number": "952-442-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871752",
            "telephone_number": "952-442-2191",
            "fax_number": "952-442-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORAK",
        "first_name": "HENRY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "38681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362227400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.