Individual provider Active NPI

Clark William Schumacher, MD

  • Vascular & Interventional Radiology Physician
  • St Louis Park, MN
National Provider Identifier
1255374450
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
50965 Issued in MN
Practice address
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone
(952) 993-5000
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 50965 MN Primary

Addresses

Primary practice location

6500 Excelsior Blvd
St Louis Park, MN 55426-4702

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

Other identifiers 1

IdentifierTypeStateIssuer
1255374450MedicaidMN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080806000549 MN Practitioner - Diagnostic Radiology 6800984964 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Minnesota Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700

1415 Saint Francis Ave
Shakopee, MN 55379-3374
Phone (952) 993-7750

15111 Twelve Oaks Ctr Dr
Minnetonka, MN 55305-5201
Phone (952) 993-4500

15800 95TH Ave N
Maple Grove, MN 55369-4400
Phone (952) 993-1440

250 Central Ave N
Wayzata, MN 55391-1206
Phone (952) 993-3123

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone (952) 993-3123

4951 Excelsior Blvd
St Louis Park, MN 55416-3033
Phone (952) 993-1300

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6000 Earle Brown Dr
Brooklyn Center, MN 55430-2506
Phone (952) 993-4900

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50965MNMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Current Accepting new patients
Stevens Community Medical Center Inc CurrentSince Jul 12, 2022 Accepting new patients
Park Nicollet Methodist Hospital CurrentSince Dec 12, 2022 Accepting new patients
Stevens Community Medical Center Inc. Current Accepting new patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Mankato Clinic LTD CurrentSince Jan 1, 2018 Accepting new patients
St. Francis Regional Medical Center CurrentSince May 22, 2019 Accepting new patients
Park Nicollet Clinic CurrentSince Dec 12, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Stevens Community Medical Center Inc CurrentSince Jul 12, 2022 Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Dec 12, 2022 Accepting new patients
Christian Unity Hospital Corporation Past Accepting new patients
Consulting Radiologists, LTD Vascular & Interventional Radiology PastSince Aug 1, 2008 Accepting new patients

Locations

7595 Anagram Dr
Eden Prairie, MN 55344
Phone (612) 573-2214

3955 Parklawn Ave
Ste 100
Edina, MN 55435
Phone (952) 285-3722

1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

7505 Metro Blvd
Ste 400
Minneapolis, MN 55439
Phone 61257322002246

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

920 E 28th St
Ste 610
Minneapolis, MN 55407
Phone (612) 863-6900

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

920 E 28th St
Ste 240
Minneapolis, MN 55407
Phone (612) 863-3850

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

400 E 1st St
Morris, MN 56267
Phone (320) 589-1313

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

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

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 8

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1255374450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264702",
            "telephone_number": "952-993-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8100 Northland Dr",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554314800",
            "country_code": "US",
            "telephone_number": "952-831-8742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHUMACHER",
        "first_name": "CLARK",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MN",
            "license": "50965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255374450",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.